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H S 



THE PRESCRIPTION 



THERAPEUTICALLY, PHARMACEUTICALS, GRAMMATI- 
CALLY AND HISTORICALLY CONSIDERED. 



BY 



OTTO A. WALL, Pn. G., M. D.. 



Professor of Materia Medica, Pharmacognosy and Botany in the 
St. Louis College of Pharmacy, Membeb of the committee for 
Revision of the Pharmacopoeia <>f tin: United States, One of 
the authors of the "companion to the united states 
Pharmacopoeia", Authob <>r u System op Pharmacog- 
nosy" AND "NOTE8 ON PHARMACOGNOSY", ETC. 



THIRD AND REVISED EDITION, 




ST. LOOS, MO. 
Published by the Aug. Gast Bank-Xot 
1898. 

L- 
TWO COPIES RECEIVED 



\<gs> 8 



!389 



ENTERED ACCORDING TO ACT OF CONGRESS, IN THE YEAR 1898, BY 

OTTO A. WALL, Ph. G., M. D. 

IN OFFICE OF THE LIBRARIAN OF CONGRESS, AT WASHINGTON, D. Cl 



All Bights Beserved. 



PREFACE TO FIRST EDITION. 



A theoretical and practical knowledge of the construction of 
the prescription is of great importance to the physician as well 
as to the pharmacist, as it is so important a feature in the daily 
life of each . 

A knowledge of prescription writing is of importance to the 
physician, because the style of his prescription is usually con- 
sidered to furnish a fair index or gauge to his professional 
accomplishments and knowledge And generally it is, per- 
haps, but fair to assume that the physician who is neat, careful, 
and correct in writing his prescriptions is also careful and 
painstaking in the examination and treatment of his patients, 
while he who is slovenly and careless in writing his prescrip- 
tions will probably allow the same characteristics to prevail in 
his treatment. 

Correct prescription writing i< an accomplishment which is to 
the physician what elegant clothes are to a gentleman, or a 
handsome frame to a tine painting. If it is not an essential part 
of his education, it at least displays his other acquirements to 
best advantage. 

A thorough knowledge of the prescription in all its relations is 
equally important to the pharmacist , as such knowledge raises 
him in the estimation of those physicians with whom he comes 
in professional or social contact. It also makes him a better 
dispensing pharmacist . 

It is hoped that the following treatise on the prescription may 
prove of interest as well as profit to the readers, and that it may 
aid, in however humble a way, to promote the cause of medical 
and pharmaceutical education. 



PHi: FACE TO SECOND EDITION. 



The first edition of this work met with a very favorable recep- [! 
Hon, and is. now exhausted. The Reviews in the Medical and 
Pharmaceutical Journals have been uniformly favorable, and hv| 
some of them 1 have found suggestions for which I feel grateful and! 
which I have utilized in this second edition. 

Especially have I thus been led to attempt a short History of the! 
Prescription, which forms Part V of this volume, and which, In 
hope, may prove of interest. 

I have aimed to make the book fairly exhaustive of the subject, 
and believe that all important facts referring to the Prescription 
may be found in it. 

In offering this, the second edition of "The Prescription", I 
would bespeak for it the same kind reception that was accorded 
the first edition. 



PREFACE TO THIRD EDITION. 



The second edition of this work having been exhausted, a third 
edition becomes necessary. In previous editions, Part I was basec 
on the Pharmacopoeia of 1880; this part has beeu rewritten anc 
rearranged, >o that now it applies to no particular edition of any 
pharmacopoeia, but treats of general principles only. This change 
- the book more valuable and will be appreciated as aBi 
improvement on previous editions. 

O. A. WALL 

;. 



n 



PART I. 

GENERAL CONSIDERATIONS. 

Meaning of ' ' Prescription . ' ' 

The word ' ' prescription ' ' is derived from the Latin word prcescrip- 
tern, which in turn is derived from prcescriptus, a, am, the perfect par- 
ticiple of the verb prcescribo, prcescribere, compounded from the prepo- 
sition prce, meaning ' 'before,'' and the verb scribo, meaning " I 
write . ' ' 

The word proescriptum^ therefore, means "that which is written 
before , ' ' and the word ' ' prescription ' ' means a formula or recipe 
which is written before , or prescribed , for the guidance of any one to 
follow in compounding any preparation . 

Strictly speaking, the Latin word prcescriptio, onis y i., means a 
heading or title , or ' ' copy ' ' in the sense in which the word is used 
by the printer; while the word prcescriptum, i , n . , means a prescrip- 
i tion in the sense in which Ave use that word . 

The word receptum , i , n. , also means a prescription (recipe or re- 
ceipt) , and is derived from the verb recepto , 1 , to accept, to take up, 
and refers to the fact that it is generally adopted or taken up in books . 
It has the same meaning as the word ' 'formula' ' (formula , ce , f . , a 
diminutive of forma, ce , f .) , which means a prescription or working 
directions ; literally , a t{ little form ' ' to go by . 

The term " prescription ' ' is generally applied only to directions 
given by a physician for the compounding of medicines for a patient, 
but is really equally applicable to written directions for the making of 
a dish of food , or a preparation for technical purposes . In a general 
sense , any directions given by the physician for the guidance of his 
patient are called prescriptions; or, rather, it is said the physician 
prescribed , for example , change of climate , an ocean trip , abstinence 
from tobacco or alcoholic drinks, or rest, or exercise, or a certain 



Id THE PRESCRIPTION . 

dirt , etc . Bui in the sense in which the medical and pharmaceutical 
professions ordinarily employ the term prescription, it means the 
written direction to the pharmacist for preparing medicines to be ad- 
ministered to the patients; or, in a more popular sense, the whole 
paper on which the directions are written is called a prescription. 

We will use the term ''prescription" in the sense in which it is 
usually understood by the medical and pharmaceutical professions, 
although under the heading of " Extemporaneous Prescriptions" we 
must also consider it in its more popular sense, and refer to some' 
other matters, besides the prescription itself, which are usually writ- 
ten on the paper. 

Simple and Compound Prescriptions. 

Prescriptions, in the sense of being written directions for com- 1 
pounding medicines , are sometimes classed as ' ' simple ' ' and l ' com- 
pound , ' ' the former of which means a prescription for a single ingre- 
dient , as when the physician prescribes a bottle of citrate of magne- 
sia , a certain number of cathartic pills, tincture of iron, or any other 
medicine expressed by writing a single name; while the compound 
prescription is one in which two or more ingredients are ordered, 
which are to be combined or compounded by the pharmacist. 

While this classification has some practical applications, it is of lit- 
tle importance, and is not generally adopted by writers on this sub-. 
ject. It is mentioned here simply for the sake of completeness, so 
that the terms may be understood when met with in the course of 
reading journals or other works where they might occur. 

Classification of Prescriptions. 

Another method of classifying prescriptions, which is of more prac- 
tical value than the above , is that of dividing them into permanent and 
( ztemporaneous prescriptions . 



Permanent Prescriptions 






contained in authoritative or recognized standard works, such as 
pharmacopoeias or dispensatories. 

"Official" and "Officinal" Prescriptions. 

i a formula is contained in a pharmacopoeia, which is pub- 

v authority -ranted to a commission or committee appointed 

•vernment of a country, or, as in our ow T n 



GENERAL CONSIDERATIONS. ]J 

30untry, by a convention of delegates from incorporated medical and 
pharmaceutical associations and teaching colleges, it is called an 
• fc official" formula, meaning that it is done by authority. Of 
course, it must be understood that such a formula is official only in 
the country in which the respective pharmacopoeia is the accepted 
authority, while in other countries, if used at all, it is only officinal. 

Official preparations are also called pharmacopoeia, which means 
the same thing. Pharmacopceial or official preparations are made, 
or should be made, of the same strength throughout the land in 
which the pharmacopoeia is the authoritative standard, and such 
preparations are therefore more generally obtainable and more 
reliable than others which are not official. 

When, however, the formula is contained in such works as the 

| dispensatories, the Companion, or any of the numerous formularies, 

it is called an "offiieinal" prescription or formula, meaning that 

i the preparation is an approved medicine kept in apothecary shops. 

The word is derived from the Latin word officina, which means " a 

shop," or, by usage, " an apothecary shop." 

Many writers make no distinction between the two words, using 
them indiscriminately, or using only the term " officinal." 

Recently the term "unofficial" has come into general use, to 
designate the formulas for those preparations which are in general 
use as substitutes for the elegant pharmaceutical specialties put up 
by various firms, such as formulas for elixirs, syrups, etc. 

Permanent prescriptions include all formulas for standard galeni- 
cal preparations, as well as for the thousand-and-one miscellaneous 
articles which are usually sold in drug stores, such as toilet prepa- 
rations, perfumes, popular remedies, etc. 

Importance of Knowing These Preparations. 

All other things being equal, that physician will be most success- 
ful in practice who has the most thorough knowledge of materia 
medica, and is familiar not only with a large number of drugs, but 
also with a great variety of forms in which to dispense them. It 
enables the physician to adapt his treatment to the peculiarities of 
his patients, if need be, as well as to the ever-changing forms of 
disease, and gives him the same advantage in regard to the fickle 
and capricious likes and dislikes of the individual that is possessed 
by the thrifty housewife, who, with a little cornmeal, butter, eggs 
and milk, knows how to serve a number of appetizing dishes- 
gruel, cakes, pudding, biscuits, etc., while another, with the same 
materials, knows only how to make the monotonous corn-bread, 
which, however good in itself, becomes disagreeable on account of 



12 THE PRESCRIPTION. 



1 



the want of change. That physician who, by virtue of his better 
pharmaceutical knowledge, avoids a prescription routine, and shows 
variety in his remedies as well as in the form of his remedies, will 
rind that he has an advantage which is not easily overestimated. 

We will, therefore, consider in these pages the various forms in 
which remedies may be prescribed and dispensed. 

Abstracts (Abstractum, i, n.). 

This name is derived from abstractus, a, wn, the perfect participle 
of abstraho, xi, ctum, meaning to draw from. The word means, 
according to Webster, " that which comprises or concentrates in 
itself the essential qualities of a larger thing." 

Many, perhaps most, of the advantages of the fluid extracts are 
offered by the abstracts, these preparations having a definite per- 
centage relation to the crude drugs from which they are made. 
They are made by totally exhausting the drug with a proper men- 
struum, adding a certain quantity of sugar of milk, varying accord- 
ing to the amount of extractive matter in the drug, and then 
evaporating to dryness. Then enough sugar of milk is added to 
make the product weigh just one-half as much as the crude drug 
weighed, and the whole is finally reduced to an impalpable powder. 

Abstracts are, in fact, powdered extracts of uniformly twice the 
strength and half the dose of the corresponding fluid extracts. 
They possess many pharmaceutical, and a number of therapeutical, 
advantages over many other of the solid preparations of the same 
drugs. 

For the prescriber the definite relation of its dose to that of the 
corresponding fluid extract (or of the drug itself) is important, for, 
while each solid or powdered extract has a different relative dose, 
as compared with that of the fluid extract, the abstract is given in 
just half the dose, and it is almost instantly soluble and, therefore, 
equally as easily absorbed as the fluid extract, but has the advan- 
tage that it contains no alcohol, and may be dispensed in capsules 
which make it tasteless, without materially retarding its solution 
and absorption. 

Capsules (Capsula, ce> /.). 

Capsules are made of gelatine and come into the trade filled and 
empty. The latter are used in extemporaneous prescribing as is 
explained farther on; the filled capsules, which usually contain 
liquid substances like copaiba, castor oil, etc., are often made 
flexible. Filled capsules are prescribed by quoting the desired 
formula of the manufacturer and the number of capsules wanted. 






GENERAL CONSIDERATIONS. 



Cerates (Ceratum, i, n.)- 

The term is derived from ceratus, a, urn, an ^ adjective signifying 

i thP artiective is derived from cera, a, f., wax. 
waxed; the adjective ,8 white ^ ^ 7Q partg of 

Cerate is made hy melt mg ™V called ,. simp ie 

ttszss&zss* - ■ dres t g ' or r a vehicle 

cerate, or w A11 cer ates contain beeswax, 

"erly Z m eZtL was nsed to designate a class of plas- 
ters wbich, as the name implies, were made without wax. 

Collodions (Collodium, *, n.)- 
The word collodion is derived from collates, is, glue-like ; in turn, 

from co»a,<B,f., glue- g un . C otton in a mixture of 

Collodion is niade by d ssoWmg « a tough colloid 

^let " «T. ^.oK *■»£«*• skin, a thin ,1m 
remains, which protects and -P^f^^.nion of a small 
Collodion may be rendered ^ e JjJ e ^ on , castor oil 

proportion of castor oil, or, as in the official p y 
and Canada turpentine, or it may be medicated. 

Confections (Confectum, i, n.). 

According to Webster, « a preparation^ fruits, roots, and the 
like, with sugar; a ^eetmeat; a comfit. ^ ^ ^^ 

Several Latin words are used to dcsigna English word, 

ceutical preparations. »*~«^^££^JU **«- 
Confectum, i, n. (that which » P"^*' *™ J^ given as the 
to bring together; to workup t< ge *«* J The word means a 
origin from which the English * 01 d u derive^ ^ ^.^ 

product of the confectioner^ art and ^aHho g ationSi 

title, it is not exactly expressrve of ^the na tur dg 

<*»* -*W»"~. £ »" »£ :;« J *-, have a similar 
The words conditio, onis, I., or ed As use d in the 

meaning. Conditio cina means J^V eans a medicinal powder, 

Pharmacopeia the word c ° nlec *7 ^^ue a pulp, or paste, 

mixed with sugar and saccharine .fluids to m 

resembling stiff ^^^^^^^^ are divided 
In some of the works on V^macj the electuaries 

into two classes, the conserves l«^^ m „ described to be 
{ eUctuariu m , i, n.). The conserves «e^om substance s, while 

preparations of moist drugs with dry 



14 THE PRESCRIPTION. 

the electuaries are dry powdered drug mixed with moist saccharine 
substances; but this distinction is not always made, nor is it always 
practicable. 

A thin, viscid electuary was formerly called an ecligmatium, i, n., 
or ecclegma, eclegma, or ecleigma, atis, n. (from a Greek word mean- 
ing to lick up). Lohochy loch or looch, n., indeclinable, or linctus, us, 
m. (from lingo, nxi, nctum, to lick up), were other terms for the 
same kind of preparation. On account of their viscidity these 
preparations had to be licked from the spoon with which they were 
administered, whence the names. Extract of malt, for instance, is 
a preparation of this kind, although the name was more frequently 
used for preparations consisting of an impalpable powder mixed 
with honey or syrup, or with a thick mucilage of acacia, quince 
seed, salep, starch, iceland moss, or carragheen. 

Decoctions (Decoctum. i, n.). 

From decoquo, oxi, coctum, to boil down. The word decoctio, onis, 
f., is also often used as the Latin title for preparations of this kind. 

A decoction is prepared by boiling a drug for some time in water 
and then straining. The strained liquid is called cola, ce, f., 
colatura, ce, f., colatum, i, n., or colamentum, i, n , in Latin, the 
preference usually being given to the word colatura. All of these 
words are derived from the verb colo, 1, to strain; to clarify. 

Some pharmacopoeias direct that decoctions or infusions be 
made of certain strengths when no directions in regard to the 
strength are given in the physicians' prescriptions, but it is better 
practice for the physician always to specify the strength, especially 
when ordering energetic or powerful drugs; and the pharmacist 
will appreciate it as a mark of carefulness on the part of the 
physician, when the latter applies this caution to all the decoctions 
and infusions which he prescribes. 

The physician would probably find a mixture of fluid extracts 
with water to be preferable to a decoction of the same drug in 
most cases, but the pharmacist would not be justified in substituting 
such a mixture when the physician prescribes a decoction. 

Elixirs (Elixir, iris, n.). 

•'Any cordial or substance which invigorates."— [Webster.] 
Elixir, ins, n., or elixirium, ii, n., are two forms of this title, either 
of which may be used, although most authorities give the pre- 
ference to the first. These words are said to be derived from the 
verb elicio, cui, citum, which means to coax forth, or to elicit. Dr. 






GENERAL CONSIDERATIONS. 15 

Charles Rice, chairman of the Committee of Revision and Publica- 
tion of the Pharmacopoeia of the United States, who is an excellent 
scholar of Oriental languages, gives the following explanation of 
the word "elixir," which is published in Professor Lloyd's work on 
Elixirs: "The word is proximately derived from the Arabic 
(al-iksir), being composed of the article al or el and iksir. * * * 
In alchemy it was used to denote the magical transformation 
powder so much sought after, a pinch of which would convert a 
whole mass of base metal into gold. * * * In later technical 
language ' elixir ' was used to denote various preparations more or 
less alchemistic, * * * and it designated any compound prepa- 
ration of supposed ' sublime ' properties, reputed to prolong life 
and to ward off disease." 

Elixirs are palatable fluid preparations containing sugar, wine or 
alcohol, and aromatics, by which the taste of nauseous medicines 
is rendered agreeable, or at least less disagreeable, or in which 
such medicines are dissolved. 

Elixirs, if well made, are elegant and valuable preparations, 
which deserve extensive application in the treatment of disease. 

Emulsions (Emulsio, oiiis, f.). 

Emulsions are liquid preparations, in which oils, oleo-resins, bal- 
sams, resins, or similar substances which are insoluble in water, are 
suspended in water by the aid of some viscid or mucilaginous 
excipient, sometimes called the emulgent (emulgens, entis, n., the 
emulsifying agent.) 

By some English writers the term emulsion is used to designate 
the same class of preparations which the United States Pharma- 
copoeia calls mixtures, so that a dry powder suspended in mucilage 
is classed in this category. 

As the term comes from the verb emulgeo, mulsi, mulsum, to 
milk, the word should be limited to the preparations having an 
appearance of milk, and we so use it. 

Some authors make a distinction between different kinds of 
emulsions, dividing them into true {emulsiones verae) and false 
emulsiones spuriae) emulsions. The true emulsions result from the 
trituration of a drug containing both the oil and the emulgent, with 
water, as when asafoetida is rubbed up with water to make the 
official mistura asafcetidce. The false emulsions are made by triturat- 
ing the substances to be emulsified with gum, mucilage, or yolk of 
egg or other emulgent, as when we emulsify castor oil with acacia. 
The older writers gave a special name to the false emulsion, calling 



10 TIIE PRESCRIPTION. 

it colostrum (colostrum, i, n., or colostra, ce, f.), the first milk of 
newly delivered woman. 

Extracts (Extractum, i, n.). 

From extraho, xi, ctum, to extract; to draw out. Extractus,us, m., 
is another, although but rarely used form of title for this class of 
preparations. 

Extracts are often spoken of as " solid extracts." Formerly, 
before the introduction of fluid extracts, they were considered to 
be the best form for the administration of various medicines, and 
they are, in fact, excellent preparations, even now, especially if it 
is desirable to administer the medicines in pill form. 

Extracts are generally of semi-solid consistence, but a few are 
dry and may be powdered. They are prepared by exhausting the 
drug with a proper menstruum, usually by percolation, and then 
evaporating to a pilular consistence by means of a water bath. 

The menstruum used for exhausting the crude drug is sometimes 
expressed in the title of the prescription, this being designated as 
"extr actum alcoholicum", or u extr actum aquosum," as the case maybe. 

Many of the extracts when evaporated to the pilular consistence 
are mixed with a small proportion of glycerin to prevent the 
extract from becoming hard and dry. 

Fluid Extracts (Extractum fluidum). 

This class of preparations is directed to be made by percolation 
in the proportion of 1 gram of drug with enough of the proper 
menstruum to make 1 cubic centimeter of the finished fluid extract 

If properly made by repercolation from the best quality of drugs, 
these preparations are by far the best, most permanent, and most 
reliable that can be made to represent the vegetable drugs. 

They are promptly active and easily absorbed; they represent 
the crude drugs more fairly than many of the isolated active prin- 
ciples, alkaloids, etc., and they deserve to be even more generally 
employed than now. They render tinctures, wines, infusions, 
decoctions, and a number of other preparations superfluous, and are 
sure to become the most popular of all pharmaceutical preparations, 
if they are not so already. 

Most vegetable drugs may be made into fluid extracts by using 
the official process, choosing a proper menstruum, according to the 
nature of the drug. Aloes, catechu and similar drugs are excep- 
tions, as one gram of drug cannot be dissolved to make one cubic 
centimeter of liquid. 



GENERAL CONSIDERATIONS. 17 

Glycerites (Glyceritum, i, n.). 

These preparations are mixtures of various substances or medi- 
cines with glycerin; tbey have also been designated as glycerolates 
(glycerolatum, i, n.), glyerols or glyceroles (glyceroleum, i, n.), 
glycerins (glycerinum, t, n.), or gly cerates (glyceratum, j, n.). 

In appearance and physical properties, as well as to some extent 
in their therapeutical uses, they resemble the medicated syrups, but 
as glycerin, which forms the bulk of these preparations, is anti- 
septic, these preparations will keep in good condition for an indefi- 
nite length of time, and the antiseptic effects of glycerin on the 
system may also prove of therepeutical value. 

Honeys (Mel, mellis, n.). 

Honey, medicated or simple, is occasionally used in pharmacy, or 
in prescriptions, generally as an excipient. 

Oxymely mellis, n., oxymeli^ itis, n. (oxy — , a prefix meaning 
sharp or acid), and acHomrl, mellis, n., are terms for a class of 
preparations consisting of honey with vinegars. Eydromel, mellis, 
n., is a mixttire of honey with water, which, when fermented, was 
formerly called "mead." 

Infusions (Infusum, i, n.). 

The term is derived from the verb infundo, fudi, fusum, to drench 
with hot water. The noun infusio, onis, f., is also occasionally used 
in prescriptions instead of the more common neuter nonn. For- 
merly all infusions were made by placing the properly comminuted 
drug in an appropriate vessel, and pouring boiling water over it, 
covering it and letting stand until cool and then straining. (See 
Decoctions.) Infusions may also be made with cold water (infusum 
frig ide par atum), and they may be made by percolation. 

Formerly a preparation called infuso-decoctum, i, n., was a prepa- 
ration made by first boiling one or more drugs for awhile, and, 
when the boiling was completed, adding another ingredient, which 
was only to be infused. 

As both decoctions and infusions have now become almost obso- 
lete, and deservedly so, such refinements of nomenclature are no 
longer in vogue. Undoubtedly the infusions, as a class, are inferior 
and unreliable preparations, which should be discarded entirely, 
and mixtures of fluid extracts and water should be prescribed 
instead. When they are prescribed, however, it would be poor 
pharmacy to dispense diluted fluid extracts in their stead. 



|3 THE PRESCRIPTION. 

The remarks made in regard to Decoctions, about specifying the 
strength in the prescriptions, applies equally forcibly here. 

Juices (Succus, i, m.) 

This class of preparations is made by forcibly expressing the 
|aioe of the fresh drugs, as of belladonna leaves, and then mixing 
with s certain proportion of alcohol to preserve them. They are 
a comparatively worthless class of pharmaceutical preparations 
which did not deserve to be official. The expressed juice of a 
3D drug was formerly called enchylisma, atis, n. (from a Greek 
word meaning juice), and when such a juice was inspissated or 
evaporated to syrupy consistence, it was called " succus inspissa- 
tes," or "roob/' as roob juniperi. The word roob is from the 
Arabic, and is either roob, is, n., or roob, n., indeclinable. 

Liniments (Linimentum, i, n.). 

A liquid preparation intended for inunction, and consisting 
wholly, or in part, of oils, volatile oils, or camphor. 

The practice of massage for the cure of rheumatic and other 
affections is often much facilitated by the use of a liniment, and an. 
attendant may be induced to rub and knead a joint for half an hour 
with a liniment, when he would not do so with his hands or gloves 
alone. 

A remedy intended for inunction by massage is sometimes known 
as confricamentum, i, n., from confrico, fricui, frictum, to rub against 
each other. 9 

Liniments are a very popular class of remedies for painful 
affections, and prove of benefit partly on account of their intiinsic 
anodyne virtues, partly owing to the accompanying employment of 
friction. 

There is also a class of liniments known as opodeldocs or soap 

liniments (saponamentum, i, n.), which consist of soap dissolved in 

alcohol and water, in such proportions as to gelatinize. With this 

simple saponament may be incorporated various other substances, 

I as camphor, opium, etc. 

Liquid Extracts (Extraction liquidum). 

A class of preparations made like fluid extracts, but other strength. 
Such are the 50 per cent solutions of aloes, catechu, etc., commonly 
sold in the trade under the name of " fluid extracts " of the corre- 
sponding drugs. It is, of course, impossible to make a true fluid 



GENERAL CONSIDERATIONS. 19 

extract of these substances, as it is impossible to have the soluble 
part of 1 gram of drug contained in 1 cubic centimeter of the 
finished fluid. 

Masses (Massa, ce, f.). 

Masses are of a doughy or pilular consistence, intended for the 
making of pills. They are kept on hand in mass and divided into 
pills as occasion requires. 

Mixtures {Mistura, ce, f.). 

This is a rather nondescript class of pharmaceutical preparations, 
including a number which cannot be well placed elsewhere. 

The term " mixture " should be restricted to those preparations 
in which a solid substance is suspended in a fluid by means of some 
viscid excipient, such as syrup or mucilage. 

Mucilages (Mucilago, inis, f.; also called Mucago, 
or Muccago, inis, f.). 

This is a class of preparations consisting of a gum or mucilagin- 
ous substance dissolved in water. They are used as demulcents, as 
vehicles for other medicines, or as excipients. 

Ointments (Ungnentum, i, n.). 

Ungnentum^ i, n., unguen, inis, n., and ungvedo, inis, f., are terms 
derived from ungo, or unguo, unxi, unctum, to annoint, and mean a 
salve, or fatty substance, which melts by friction at the temperature 
of the body, and which is intended for inunction. Kennedies used 
in ointments are usually intended for absorption, although occasion- 
ally for local or external effects. 

Enchrisma, atis, n., or chrisma, atis, n., also means a salve, but 
the term more properly means a remedy to be applied with a brush, 
and a similar term, enchristum, i, n., means either a salve or lini- 
ment, or a remedy for inunction. 

Ointments are usually dispensed in small jars, or gallipots, which 
are designated by various terms in Latin, of which olla, ce, f.,pot, 
was most commonly used. Ollula, ce, f., ollicula, ce, f. (diminutive 
of olla), myrotheca, ce, f., and myrotheciitm, ii, n., all mean galli- 
pot, or ointment jar. Narthex, ecis, f., nartheca, narthecia, or nar- 
thecya. ce, f., and narthecium, ii, n , are terms originally meaning a 
box turned or made out of narthex wood to contain medicine, and 



20 v THE PRESCRIPTION. 






these terms afterwards were used to designate ointment jars, 
although they are equally applicable to a medicine chest. 

Alabastrum, i, n., was an ointmeut jar cut ft 3m alabaster in the 
form of a rose bud, and was used for perfumed unguents, or 
pomades. Pomata, ce, f., &nd pomatum, i, n., is a perfumed ointment 
used for cosmetic purposes. 

Oleates (Oleatum\ t", n.). 

Oleates are combinations of various bases with oleic acid, ordina- 
rily dissolved in an excess of oleic acid; or, by double decomposi- 
tion, the oleates are produced without an excess of oleic acid, the 
bulk of the preparation then being made up of simple cerate, 
petrolatum, or other fat. The oleates are said to be absorbed more 
readily by the skin than are ointments. 

Oleoresins (Oleoresina, ce, f.). 

There are quite a number of natural oleoresins which are used 
in medicines, such as copaiba and others. There is, also, a class of 
official preparations of this name, which includes oleoresins (a 
natural combination of a volatile oil with a resin), which are 
extracted from crude vegetable drugs with ether, which latter is 
afterwards distilled off or allowed to evaporate. 

Papers (Charta, ce, f.). 

Charta, ce, f ., is a Latin word which has several meanings, of which 
the most common is paper; but it also means that which is written 
on paper, an epistle, a deed, a charter (magna charta, for instance); 
or a thin plate, as charta plumbea, sheet-lead. Adjectives added to 
the word charta, specify various peculiarities, as charta bibula, blot- 
ting paper; charta densata, paste-board; charta exploratoria, reagent 
paper, or litmus paper; charta cerata, waxed paper, etc. 

It would, therefore, seem to have been advisable to have called 
this class of preparations chartce medicatce, or medicated papers. 

Papers are prepared either by saturating bibulous paper with 
some solution and then drying, or by coating one surface with a 
mixture of medicinal substances. Nitrate of potassium paper is an 
example of the first, and mustard paper of the second kind. 

Pills (Pilula, ce, f.). 

The word pilula is a diminutive of pila, ce, f., which means a 
mortar, a pile (as pila electrica, a galvanic pile), a ball, or a sphere. 
The term pilula, however, only means a little sphere, or, a pill. 



GENERAL CONSIDERATIONS. 21 

Many remedies can appropriately be dispensed in pill-form, and 
this class of preparations is quite popular. Nevertheless, this 
method of administering medicines has serious drawbacks, owing 
to the frequent insolubility of the pill and the consequent want of 
absorption. It is true, that this is not always due to the pill itself, 
but to the condition of the patient, but the result is the same; often 
pills will fail to act when the corresponding remedies in a fluid 
state, as in fluid extract, would act promptly. The applicability of 
pills is, therefore, limited, and careful physicians will rather pre- 
scribe remedies in a form more easily and surely absorbed. 

Pills are used plain, or nncoated ; sugar-coated, or gelatin- coated. 
Of these three forms, the uncoated pill, probably, is most readily 
absorbed, but the coating of the gelatin-coated pill is also so easily 
dissolved that there is not much therapeutical disadvantage in 
giving the gelatin-coated rather than the uncoated pills, while 
there are a number of advantages which far outweigh the very 
slight retardation of solution, of which the permanance and taste- 
lessness are two. The sugar-coated pill is least soluble of the 
kinds mentioned. 

Some "few pills containing deliquescent salts, as iodide of iron, 
etc., are coated by rolling on a plate in a solution of balsam of tolu 
in ether, the ether leaving a resinous coating upon evaporation. 
These pills are possibly less readily absorbed than the sugar-coated 
pills, but as the latter are often coated in a similar way with 
a solution of shellac in alcohol before being coated with sugar, 
so as to prevent the sugar from being discolored by the pill 
mass; such sugar-coated pills are less soluble even than the tolu- 
coated. 

The dragee (a French word, dragee; Latin, tragea, ce, f., drageta, 
(B, f., or trachema, ati** n.), means a sugar-coated pill. The Latin 
terms also mean a pastille or a coarse powder, or occasionally, also ? 
a sugar tablet. 

The granule (granellum, i, n.. or granulum, i, n., diminutives of 
granum, i, n., a grain or kernel) is a very small pill for the adminis- 
tration of very active remedies, such as alkaloids. This is a favor- 
ite preparation with homoeopaths. 

The bolus (bolus, i, m., a choice bit, nice morsel, a mass or 
lump) is a very large pill, or any rounded mass larger than 
a pill, but intended to be swallowed at once. Its use is almost 
entirely restricted to veterinary practice now. The same word in 
the same form is also feminine, bolus, i, f., which means an 
argillaceous earth, or bole, as bolus alba, and bolus rubra, white and 
red bole. 



22 THE PRESCRIPTION. 

Plasters (Emplastrum, i, n.). 

The word emplastrum, plaster, means an adhesive, fatty, or resin- | 
ous compound, which is sold either spread on muslin, leather, cm 
other textile fabric (spread plaster, sometimes called sparadrapus, 
i, m., sparadrapa, ce, f., or sparadrapum, i, n., all three forms being 
used), or in rolls (formerly called magdaleon, onis, f., thus, magda- 
leon emplastri diachyli y roll of lead plaster). 

So-called u isinglass plaster " (emplastrum ichthycollce) consisting 
of a solution of isinglass spread and dried on thin silk or taffeta, is 
also called sericum adhcesivum (sericum, i, n., silk). 

Fatty plasters are adhesive at the temperature of the body, but 
solid at ordinary temperatures. Surgeons' adhesive plaster, emplas- 
trum adhcesivum, is lead plaster spread on muslin. 

Formerly a number of terms were in use, such as emplastrum ad 
clavos, corn-plaster; emplastrum ad fracturas, plaster for dressing of 
fractures; emplastrum conglutinans, sticking plaster; emplastrum 
defensivum, protective plaster; emplastrum stypticum, styptic plas- 
ter, etc. 

Curiously enough the term emplastrum diachylon, which now 
means lead plaster, originally meant any plaster made from the 
juice of plants, and was applied to lead plaster because this was 
formerly made with the juice or mucilage of marshmallow. 

Powders (Pulvis, eris, m. or f.). 

While pulvis can be used either as a masculine or feminine word, 
it is customary to use it only in the masculine gender, so that 
adjectives are also written in the masculine form to agree with it, 
and we write Pulvis compositus, and not composita. 

Powders in divided doses, as generally prescribed, were formerly 
called u pulvisculi" (plural of pulvisculus, i, m., or pulviusculus, i, 
m., the dimunitive of pulvis), but are now called "pulveres." 

Resins (Besina, ce, f.). 

% As in the case of oleo-resins, there are quite a number of natural 
resins in use, and also several preparations of resins made by the 
pharmacist. The latter are made by precipitating from concen- 
trated alcoholic tinctures by pouring into water. The title " resin ,? 
applies to both kinds of resins. 



GENERAL CONSIDEARATIONS. 23 

Solutions (Liquor, oris, m ), 

The official Latin title, liquor, means a liquid, and, therefore, if 
literally translated, is a title having little or no meaning. The 
English name, solution, is not a translation of the Latin word, but 
of another word, solutio, onis, f., which means a liquid holding 
something in solution. This Latin word, solutio, therefore, is a 
much more appropriate and expressive title, and should be pre- 
ferred to the meaningless title " liquor;" or, the English word 
should have been a different one, so that the name solutio, both 
Latin and English, might have been altogether used to designate a 
class of extemporaneous preparations commonly designated as 
solutions, which are essentially different from the pharmacopoaial 
solutions. 

Most of the solutions are solutions of chemicals or alkaloids in 
water, but in some the solvent is something else; diluted alcohol 
in solution of citrate of iron and quinine, chloroform in soluion of 
gutta-percha, etc. 

" Species " (Species, ierum, f. pi.). 

The plural of the word species, ei, f., is used in pharmacy to 
designate a mixture of coarse vegetable powders, used for teas, or 
to macerate in liquors to make " bitters," as in the case of the 
well-known species ad longam vitam, or the equally well-known 
species pectorales or " pectoral teas." 

Species are commonly used to make teas, but are more frequently 
called for by the laity than prescribed by physicians. Mixed with 
hot water, some species are used to make poultices, also called 
cataplasms (cataplasma, atis, n., or also formerly chliasma, atis, n. 
A dry poultice, consisting of a species sewed in a small bag and 
applied warm, as the popular sack of bran, cornmeal or chamomile 
for toothache, was called saccellatio, onis, f . Formerly, and perhaps 
now, small bags with camphor were worn over the chest, suspended 
by a ribbon about the neck, to keep off cholera or other infectious 
diseases; more recently " liver pads," and innumerable other 
patent " pads," were also much used; such a sac, with its con- 
tents, was called saccellus, i, m., or when it was larger and used as 
a pillow it was called cataclitum, i, n., as cataclitum humuli, hop 
pillow. Some of the modern pillows advertised as catarrh reme- 
dies, might be also classed here. 

When these sacs, with their contents, were used as amulets for 
superstitious reasons, as when the negroes of to-day buy and 
carry about themselves " female " loadstones to attract the 
females, while the negresses carry "male" loadstones to attract 



24 THE PRESCRIPTION. 






the males, then they were called bambaceutria, orum, n., mean- 
ing fetishes, charms, spells, or witch-remedies. The " love- 
powders " often called for even in this enlightened age, would also 
be bambaceutria. The same word also means poison, and the art of 
mixing these remedies was called bambacia, ce, f. (the mixing of 
poisons — Gift-mischerei, G.) To counteract these spells, other 
remedies were worn about the body, generally in small sacs 
suspended about the neck; such a remedy against witchcraft was 
called bascanium, ii, n. Articles used as charms for good are now 
called mascots, and the charms for evil are called hoodoos. 

These various remedies constituted a considerable part of the 
stock of the apothecary in the days of Shakespeare, if we may judge 
from the description in Romeo and Juliet, but it is not unusual that 
demands for them are made on the druggist of to-day. It is sur- 
prising to what extent similar remedies are worn even at the 
present time. The potato or buckeye worn in the pocket to ward off 
Bright's disease or rheumatism; or the loadstones; or many of the 
galvanic belts, scrotal supporters, soles, etc; the clover leaf for 
good-luck; or the amulets from Lourdes; the little sacs with 
pictures of saints pasted on them, hung around children's necks to 
prevent diphtheria, or around the necks of thousands of apparently 
intelligent people to ward off evils of all kinds, all belong to the 
same category of bambaceutria, but the sale has been transferred 
from the apothecary shops of " ye olden time " to the bookstores 
of the present; nor is it the medical profession which prescribes 
them at the present time. 

When species are ordered for the purpose of making an infusion 
from them, into which flannels or cloths are to be dipped while it is 
still hot, and then applied to the body, or parts of the body, such a 
remedy is called a fomentation, or, in Latin, fotus,us, m.,fomentatio, 
onis, f., or /omentum, i, n. A flannel wrung out of hot chamomile 
tea, over which turpentine is sprinkled, would be a remedy of this 
kind. 

Spirits (Spiritus, us, m.). 

Spirits are solutions of volatile substances in alcohol, obtained 
either by distillation or by solution ; volatile oils, or other volatile 
substances or gases, such as camphor or ammonia, are thus dis- 
solved. 

Suppositories (Suppositorium, ii, n.) 

Suppositories are medicines mixed with cacao butter and formed 
into small cones, to be used for insertion into the rectum or vagina. 
When for the first, they are also called rectal suppositories, and for 



GENERAL CONSIDERATIONS. 25 

the second, vaginal suppositories. Sometimes they are made with 
gelatin and glycerin. 

A vaginal suppository is also sometimes called pessum, i, n., 
or pessarium, ii, n., a vaginal suppository, a pessary. 

When intended for insertion into the urethra, uterus, nasal pas- 
sages, or eustachian tube, they are called bougies (bougia, ce, f.), 
from a French word meaning wax-candles. 

Unless otherwise specified in the physician's prescription, sup- 
positories are made to weigh about 15 grains or 1 gram. 

Syrups (Syrupus, i, m.) 

These are solutions of various kinds, containing large quantities 
of sugar (60 to 65 per cent). 

Some syrups are medicated and present the remedies in a palata- 
ble form; others are only flavored, and are used as excipients in 
extemporaneous prescriptions. 

Syrups made by dissolving sugar in vegetable infusions are lia- 
ble to ferment, and should therefore be made in limited quantities 
and kept in a cool place. 

Tinctures (Ti?ictara, a, f.) 

The word is derived from the verb tingo (or tinguo). nxi, nctum, to 
color, and literally means either the process of coloring, or a 
colored extract. 

In pharmacy the word means a solution of the medicinally active 
constituents of drugs, or a solution of a chemical or chemicals, in 
an alcoholic menstruum. The solutions of chemicals, as of iodine 
in alcohol, should be called solutions, rather than tinctures, limit- 
ing the latter term to weak alcoholic preparations from organic 
drugs. 

According to the menstruum which is used, different names have 
been given to the preparations. Thus, a tincture made with 
alcohol alone, is sometimes called alcoholatura, ce, f., when it is an 
extract from organic substances, while a solution of a chemical in 
alcohol was called alcoholativum, z, n. The first of these terms is 
used in the French Codex, with a slightly modified meaning. 
(See Tinctures of Fresh Herbs.) 

A tincture containing vinegar or acids was sometimes called 
acetolatura, ce, f., and a tincture containing ether was designated as 
cetherolaturum, i\ n., or etheroles as in the French Codex. 






26 THE PRESRIPTION. 

Tinctures of Fresh Herbs (Tincturce Herbarum Becentium) . 

This formula gives general directions for making these : 

Take of 

The fresh herb, bruised, or crushed _ 50 parts. 

Alcohol 100 parts. 

Macerate the herb with the alcohol for fourteen days; then 
express the liquid and filter. 

In the French Codex these tinctures are designated as alcoolatures 
(alcoholatura, ce, f.). 

Triturations {Trituration onis, f., or tritura, ce, f.) 

The term is derived from the verb tero, trivi, tritum, to rub fine* 

The following gives a general formula : 

Take of 

The substance 10 parts. 

Sugar of milk, in moderately fine powder 90 parts. 

To make 100 parts* 

These substances are to be thoroughly mixed. 

Troches (Trochiscus, i, m.) 

The term trochiscus, meaning troche or lozenge, is applied to 
a small flattened cake, made from sugar and gum or other adhesive 
substance, with which medicinal ingredients have been incorpor- 
ated. These are worked into a mass and rolled out flat, and from 
this the troches are punched with dies of oval, round, octagonal or 
other forms; or troches may be made by compression. Troches 
are used mainly for local effects on the mucous membranes of 
the mouth and pharynx, by allowing them to dissolve slowly in the 
mouth. 

The word tabula, ce, f., or the diminutive tabella, ce, f., a small 
plate, a tablet, is sometimes used to designate the same kind of 
preparation. 

Another term, pastilla, ce, f., a pastil (diminutive of pasta, ce, f. t 
dough or paste), is a term applied to a class of preparations mainly 
used for fumigation. The fumigating pastilles (jpastillce fumales), 
are small conical bodies, which, when ignited, are slowly con- 
sumed, emitting perfumed odors as they burn. They may also be 
used as moxas (moxa, ce, f .), by burning on the skin. 

The word rotula, ce, f. (diminutive of rota, ce, f., awheel), desig- 
nates a small disc of sugar which is impregnated with alcoholic 
solutions of ethereal oils, as in the well-known " peppermint 
drops." Botulce sacchari are the little sugar tablets before the fla- 
voring spirit has been added. 



GENERAL CONSIDERATIONS. 27 

The disc (discus, i, m., from a Greek word meaning a plate, a disc) 
is a small circular troche of gelatiD, with which medicinal agents 
: are incorporated. They are made to dissolve in water for subcuta- 
neous injection, or occasionally for use by oculists to apply atropine 
or other remedies to the eye. 

Vinegars (Acetum, i, n.). 

Vinegars are made by extracting the active constituents of drugs 
with wine vinegar, or with diluted acetic acid. They are not a very 
elegant class of preparations, and, with the exception of vinegar of 
squill, are not very often used. 

The menstruum or fluid used to make vinegars was formerly 
called acetolotivum, i % n., an acidulated fluid. An infusion made 
with such a menstruum, instead of water, was an acetolatum, t, n.; 
or a tincture containing vinegar was an acetolatura, ce, f . ; a mixture 
of a medicated vineger with honey was called oxymel or acetomel 
[see Honeys], aud foods made with vinegar, such as salads or 
pickles, were acetaria, orum^ n ; acetositas, atis, f., the sour, that 
which is sour, was a term occasionally employed, as, for instance, 
acetositas citri, lemon juice, literally, the sour of lemons. 

Waters (Aqua, at, f.) 

This class of preparations is often spoken of in the dispensatories 
as " Medicated Waters " (Aquce medicatve), although that is not the 
pharmacopoeial title. Waters which have been made aromatic with 
volatile oils, are also called " Aromatic Waters " (Aquce aromaticce). 
They are used as diluents in extemporaneous prescriptions. 

The plural of aqua, or aquce, arum, f., formerly meant mineral 
waters, or watering-places. In this §ense, Saratoga or Hot 
Springs were " Aquae. " We now speak of mineral waters as aquw 
minerales, and of waters charged with carbonic acid as aquce aeratce. 
Artificial mineral aerated waters are much used, and are dispensed 
in syphons. In the prescriptions they are commonly designated by 
their vernacular names, and not by Latin titles. Well-made arti- 
ficial mineral waters are to be preferred to the natural waters, 
except when the latter are drunk fresh at the springs. 

Wines (Vinam, i, n.). 

Natural wines are frequently prescribed by physicians. There is, 
however, also a class of pharmaceutical preparations, consisting of 






23 THE PRESCRIPTION. 

tinctures, in which wine is used as a menstruum, and these prepara- 
tion are called "medicated wines," or simply "wines." Medicated 
wines have about the same pharmaceutical and therapeutical value 
as the corresponding tinctures. 

There are a number of valuable "elegant" pharmaceutical prepa- 
rations, such as " Beef, Wine and Iron," " Beef, Wine and Iron with 
Cinchona," etc., which combine tonic and stimulant properties 
with an exceedingly pleasant taste, and which are therefore 
deservedly popular. 

Wines of this latter kind are preparations of essentially the same 
class as elixirs. 

Many Other Preparations, 

such as baths, enemas, gargles, potions, injections, etc., are some- 
times officinal, but are more usually prescribed extemporaneously, 
and will be considered when we reach the subject of extemporane- 
ous prescriptions. 

PATENT AND PBOPBIETABY PBEPABATIONS. 

By these titles preparations are designated which are made 
according to formulas originated by individuals or firms who hold a 
copyright on the name or a patent on the composition of the rem- 
edy, which latter they keep secret. Some of these preparations are 
put on the market by advertising them directly to the consuming 
public through the daily papers or by the distribution of almanacs, 
and these medicines are called " patent medicines." The manufac- 
ture and sale of patent medicines has assumed immense propor- 
tions, mainly on account of the moral support which it has received 
from the members of the pharmaceutical profession, by allowing 
their names and addresses to be printed on the covers of the almanacs 
and circulars, and then distributing them to their customers. This is 
generally looked upon by the public as an indorsement of the state- 
ments of the almanac by the druggist, and it is probable that with- 
out such presumed indorsement many now popular remedies would 
not have achieved any success. Many patent medicines, of course, 
are worthless, but some possess considerable merit, and serve a 
valuable purpose in sparsely settled districts where it is impossible 
to obtain proper medical attendance. 

Another class of preparations has recently become popular with 
many druggists as a substitute for patent medicines. They differ 
from patent medicines only in having either a real or pretended state- 



GENERAL CONSIDERATIONS. 29 

t nent of the composition of the contents printed on the label, and the 
I name of the retail druggist on the wrapper instead of on the cover of 
the almanac . By closely imitating the style of putting up , and even 
| the names of well-known and well-advertised patent medicines, these 
I so-called ' ' non-secret' ' remedies have come into extensive use and 
offer better profits than the corresponding patent medicines . 

It is not our object to discuss the ethical questions which are in- 
volved in the sale of either the "patent" or "non-secret" medi- 
cines , but we leave this for each one to settle in his own mind . 

A number of very valuable remedies have recently been introduced 
into general use, and are extensively prescribed by physicians, which 
are only made by one manufacturer, because he holds a patent on the 
process of production . It seems but right that when anyone has 
devoted much time, study, and money to the discovery and elabora- 
tion of a valuable process of making a meritorious article, that he 
should be protected by letters patent in the utilization of his process . 
In this case no one is prevented from making the same remedy by 
another, essentially different process, if he can. Such a remedy, 
though only obtainable from the patentee of the process, is not in any 
sense a patent medicine, and should not be so considered. 

The copyrighting of the name of a preparation does not patent the 
process nor the combination of remedies, but leaves it free to every 
one to make a similar preparation, but prevents him from using a 
similar name . As the demand for many of these preparations is 
exclusively due to advertising, and as they have a sale only under cer- 
tain names, it is clear that this secures the benefits of advertising to 
the one who pays for it. Many of these preparations are intended to 
be prescribed by physicians , and are not advertised to the general 
public. It is a legitimate business enterprise to make such prepara- 
tions , for no one is compelled to use them unless he chooses to do so , 
and if a physician desires to prescribe them, he can well enough 
afford to let the profits go to the one who originated the article; nor 
would it be honest for the dispensing pharmacist to put up something 
else without the knowledge or consent of the prescriber. 

There is still another class of preparations , sometimes called pro- 
prietary, the formulae for which are common property, such as vari- 
ous elegant pharmaceutical preparations , elixirs , wines , syrups , etc . , 
but different firms either claim to possess, or really do possess, 
better facilities or greater knowledge and skill in making them, so 
that the products , though similar in name , are really different in 
regard to medicinal worth . This applies , also , to regular pharmaco- 
pceial preparations, such as fluid extracts and chemicals, and it is 
in regard to these preparations that the propriety or impropriety of 
specifying in prescriptions is most hotly contested . 



30 the prescription. 

1 ' Specifying ' ' in Prescriptions . 

On this subject the author of these pages submitted a paper to the 
American Pharmaceutical Association at its meeting , in Milwaukee , 
Wis. , August, 1884, which was printed in its proceedings, and from 
which we reprint the following : 

The question , to what extent a physician is justified in specifying: 
certain preparations in his prescriptions , is one to which widely dif- 
ferent answers are apt to be given , according to the pecuniary and 
business interests involved . Many pharmacists take the ground that 
it is unprofessional for the physician ever to specify a certain manu- 
facturer 's pills, fluid extracts, elixirs, etc., while others freely ac- 
knowledge his right to do so . 

This question is one which can best be answered by looking at it 
from the physician's standpoint, for if it is to his own and his 
patient's interest that he should specify, then it is proper for him to 
do so. The physician's duty to his patient is not comprised merely 
in the visit, the diagnosis, and the written prescription, but it in- 
cludes also the responsibility for the proper execution of his orders . 
The physician owes it to his patient to see that he is placed under the 
best possible conditions for an early restoration to health , to provide 
proper hygienic surroundings, to regulate his baths, his diet, and 
nursing, and last, not least, to see that the proper medicines are ad- 
ministered at the necessary time . 

In other words , the physician must regulate and control every in- 
fluence that may restore his patient to health , and the neglecting or 
slighting of any of these things is a sin of omission towards his pa- 
tient , who looks to him for his chance of recovery . Not only is it 
necessary to do all this for the patient's sake , but it is for the physi- 
cian 's own good that he should attend to all these matters . Success 
in any pursuit in life depends upon an attention to details, and the 
physician who pays attention to all the details , that may or may not 
assist in rescuing his patient from threatened death , is more success- 
ful than he who contents himself with merely writing a prescription 
and giving a few general directions, which, from the careless man- 
ner in which they are frequently given , do not impress themselves 
upon the attendant's mind as important, and are neglected to the 
imminent peril of the patient . 

One of the details often overlooked by the physicians , to their own 
and their patients' lasting injury, is the looking after the character 
of the medicines dispensed on their prescriptions. 

Many pharmacists speak and write as if they think that it must be 
taken for granted that every pharmacist is honest, and in all regards 
— ability, education, and business tact — equal to every other pharma- 






GENERAL CONSIDERATIONS. 31 

cist. But is there anything iu the profession of pharmacy that com- 
pels us to believe this? Do the gentlemen claiming this believe it 
themselves? 

Can they not always point out to the physician reasons why he 
6hould use their own prescription blanks, and send his patients 
to them for their medicines? The fact is, the business of pharmacy 
is like any other business or calling in life. Pharmacy is followed by 
able, mediocre, and incompetent men — by honest, indifferent, and dis- 
honest men. 

Mankind is the same all the world over, and when there are retail 
pharmacists who are indifferent to the quality of goods they dispense, 
and consider only the price of the goods in determining which they 
will buy, there will also be manufacturers who will make cheap prepa- 
rations, and wholesalers who will supply them. The trade adapts 
itself to the requirements, and the demand regulates the supply. 

Every pharmacist knows that preparations are often offered in the 
market for less than the ingredients of an honestly made preparation 
would cost. If he buys this preparation, is he not guilty of encour- 
aging and abetting dishonesty? Does the plea that he does not know 
the character of the preparation, but supposes it to be ail right as 
long as he hears no complaint, exonerate him from the charge that 
he is willfully jeopardizing human life and health for the sake of pecun- 
iary profit? Is he any more honest than one who would substitute 
cinchonine for quinine, or would only give half weight or measure of 
important medicim 

Does not the fact that price lists quote "commercial red cinchona" 
at 14 cents a pound prove that such stuff exists and is consumed as 
red cinchona? And is it not likely that "cheap" goods are made from 
cheap materials? 

Every one knows that there are honest and dishonest pharmacists, 
honest and dishonest manufacturers, and honest and dishonest goods 
in the market, and the latter kind is by no means rare. Could we 
believe that every pharmacist was honest and competent, and that all 
medicines were equally efficient, there would be no necessity for the 
physician to specify. 

When we have a valuable watch that needs repairs, we do not take 
it for granted that every one who has a sign before his door an- 
nouncing himself to be a watchmaker is, therefore, to be trusted with 
our watch, but we will pass a dozen watchmakers and go a long dis- 
tance to take our watch to one we know to be a competent workman. 
If, then, we are so particular about our watch, why should we not 
be equally particular about our much more valuable selves? When 
we choose a physician, we try to do so intelligently. We have, or 
think we have, reasons why we prefer our physician to the great num- 



32 THE PRESCRIPTION. 

bcr of other physicians around us. Why should we act differently in 
regard to the pharmacist, and prefer the one who happens to live near- 
est to us merely on account of this fact? Should we not rather, as 
patients, prefer to send our prescriptions to one whom we know to be 
competent and honest, rather than to those who may be equally hon- 
est and able, but about whom we know nothing — or, as the patient 
frequently can not judge, is it not best to trust our physician to choose 
for us, when his interests and ours are so intimately interwoven, for 
our health and the physician's reputation alike depend upon thei 
quality of the medicine dispensed? Kay, even more, is it not to the 
honest and competent pharmacist's interest that business probity, and 
integrity, and professional ability should be recognized and appre- 
ciated? It is plainly the duty of the physician to advise the patient 
how and where to obtain the best medicines, and he does so generally 
by using the prescription blank of the pharmacist whom he prefers. His 
use of such a blank is clearly a specification of the preparations of 
that particular pharmacist, and an indorsement of them. It does not 
seem to occur to those who argue against the physician's right to 
designate a certain manufacturer's preparations that he is equally 
wrong and unprofessional when he uses their blanks. If one is wrong, 
the other must be the same. In one case, it is an indorsement of a 
wholesale manufacturer, in the other case of a retail manufacturer, 
with the advantage in specifying the wholesale manufacturer's goods i 
that he can obtain them everywhere and anywhere, while the others 
are obtainable only in one drug store. 

We must admit that there is a difference, and often a great differ- 
ence, between the various preparations sold under the same name; 
that some are almost worthless, others very active. No matter if we 
try to argue that ours is just as good; the physician is entitled to get 
what he prescribes. 

The retail pharmacist may convince the physicians in his neighbor- 
hood that he has the best and purest medicines, in which case the 
physicians will no doubt allow him to use his own preparations. We 
have known of physicians who specified certain preparations, but 
have given permission to individual druggists to use their own prepa- 
rations when the prescriptions were :aken to their drug stores. 
There is no objection to this; it is rarely the case that the physician 
specifies except in the case of the more important remedies, or when 
he is not sure to which drug store his prescription will be taken . In 
regard to the majority of ingredients, he leaves the choice to the phar- 
macist's judgment. When he does specify, his wishes should be re- 
spected and complied with as far as possible. 

To conclude, then, it is the writer's belief, based upon many years' 
experience, that the physician is derelict in a part of his duty if he 



GENERAL CONSIDERATIONS. 33 

I 

I does not see to it that his patient obtains proper medicines and he is 
I equally unmindful of his own best interests. 

He should, therefore, specify to the extent that he may know that 
I proper remedies are dispensed, either by directing the patient to go to 
I a certain drug store, or by specifying a particular preparation with 
I which he is familiar, and in which he has confidence, and it is cer- 
tainly wrong for him to show less interest in so important a matter 
I as medicines, than he shows in regard to his wearing apparel, his 
I food, or fuel, or any other commodity in regard to which he exercises 
an intelligent choice. 

FORM OF FORMULAE. 

The manner of writing permanent prescriptions does not vary much 
in different w T orks, or even in different countries. Generally the 
names of the ingredients are written in one column, and the quanti- 
ties in another column to the right. 

The oldest pharmacopoeia of which we have any knowledge is a large 
and very well preserved papyrus found about 1858 in the Necropolis 
at Thebes. This papyrus is supposed to be one of the six works 
on medicine ascribed to the God Hermes (Egyptian Thoti), and was 
probably compiled and written at the great university at Thebes, about 
1550 B. C, or at a time previous to the exodus of the Israelites from 
Egypt, or when Moses was still a young man. In this work the ar- 
rangement of the formulae, including such for decoctions, confections, 
pills, etc., are written according to the plan mentioned above, as will 
appear from the following translation of one of the formulae from the 
ancient hieroglyphics : 

For Sick Intestines. 

Fennel seed V64 drachma. 

Goose fat Vs drachma. 

Milk 1 tenat . 

Boiling, stirring and eating. 

In these most ancient formulae, no introduction was used, but the 
writer, or writers, proceeded at once to the enumeration of the med- 
icines, in this respect resembling the usage in the United States Phar- 
macopoeia. As in this latter work, the directions for compounding 
and for using the medicines also follow after the formula itself. 

In modern works, this same plan of one column for ingredients and 
one for quantities is generally adopted, because such an arrangement 
allows the reader to have a better oversight over the whole prescrip- 
tion, and, therefore, aids in avoiding mistakes in compounding. 



34 THE PRESCRIPTION. 

We copy the following from the Pharmacopoeia (1880) : 

Pilulje Ferri Iodidi (Pills of Iodide of Iron). 



Grains . 

Reduced Iron, sixty grains 60 

Iodine, eighty grains 80 

Glycyrrhiza, in No . 60 powder , fifty grains. . . 50 

Sugar, in fine powder , fifty grains 50 

Extract of Glycyrrhiza, in fine powder, twelve grains 12 

Acacia, in fine powder, twelve grains... 12 

Water, 

Balsam of Tolu, 

Stronger Ether, each, a sufficient quantity 

264 



Grammes 
4.00 
5.20 
3.25 
3.25 
0.75 
0.75 



17.20 



To make one hundred pills 100 

"To the Reduced Iron, contained in a porcelain capsule, add about one 
hundred and twenty (120) grains, or about eight (8) grammes of Water, and 
gradually add the Iodine, constantly triturating nntil the mixture ceases to 
have a reddish tint . Then add the remaining powders, previously mixed, 
and evaporate the excess of moisture on the water-bath, constantly stir* 
ring, nntil the mass has acquired a pilular consistence. Lastly, divide it 
into one hundred (100) pills. 

"Dissolve one (1) part of Balsam of Tolu in one (1) part of Stronger Ether, 
shake the pills with a sufficient quantity of this solution until they are 
uniformly coated, and put them on a plate to dry, occasionally stirring 
them until the drying is completed. 

"Keep the pills in a well-stopped bottle." 

In this formula we see an example of an unusually fully and care- 
fully constructed formula. Not only are the names of the ingredients 
made prominent by a heavier type and capitalization, and the quanti- 
ties expressed in both the ordinary apothecaries' weight and metric 
weights, but quantities are also printed in italicized words, so that a 
mistake in compounding can only be due to carelessness. 

Ordinarily such a formula would be written somewhat differently, 
and would commence with an imperative "take" or "take of," so 
that this formula would, perhaps, read as follows : 

Take of 

Reduced iron 60 grs. 

Iodine 80 grs. 

Glycyrrhiza, powdered 50 grs. 

Sugar, powdered 50 grs. 

Extract of glycyrrhiza, powdered 12 grs. 

Acacia, powdered 12 grs. 

Water q. s. 

Mix. Divide into 100 pills; coat with tolu balsam. 

Instead of giving full directions for making the pills it is here taken 
for granted that the pharmacist possesses enough knowledge to make 
the pills without them. The full directions for making the pills might, 
however, be given just as well with this formula as with any other. 

Still another method of writing the formula would be to intersperse 
directions with the ingredients. 



GENEKAL CONSIDERATIONS. 35 

Take of 

Reduced iron 60 grs. 

Place into a porcelain capsule and add 

Water 2 fl.drs. 

Add gradually with constant «tirr Vng 

Iodine 80 grs. 

Mix together 

Powdered glycyrrhiza 50 grs. 

Powdered sugar 50 grs. 

Powdered extract of glycyrrhiza 12 grs. 

Powdered acacia 12 grs. 

Add to the contents of the capsule. Mix thoroughly and evaporate to pil- 
ular consistence. Divide into 100 pills. Coat with tolu balsam. 

This formula is easily followed and compounded, and, therefore, 
this is a very good method of writing working formulae. 

Probably the least desirable method is to write the formula in the 
form of solid matter straight across the lines, as in the following ex- 
ample : 

" Take 60 grains of reduced iron and place it into a porcelain capsule with 
2 fluidrams of water. Add 80 grains of iodine, stirring constantly until the 
mixture assumes a reddish tint. 31 ix separately 50 grains each of powdered 
glycyrrhiza and of powdered sugar, and 12 grains each of powdered extract 
of glycyrrhiza and of powdered acacia, and add the powders to the contents 
of the capsule. Mix all together thoroughly and evaporate to a pilular con- 
sistency, and then divide into 100 pills. Coat the pills with tolu balsam. ' ' 

Of these different methods of writing formulas the best one for gen- 
eral use is an enumeration of all of the ingredients and quantities in 
two parallel columns, and then the directions for compounding, un- 
less the latter is so simple that no directions are needed. 

Whenever practicable, the best plan of constructing a formula is to 
use " parts by weight," as in the United States Pharmacopoeia, instead 
of giving actual weights or measures, but of the many and great ad- 
vantages of this method we will speak further on in the proper place. 



PART II 



WEIGHTS AXD MEASURES. 

System of Numeration. 

When primitive men had advanced so far in civilization that ex- 
actness in all their dealings became desirable, then some system of 
counting and expressing quantities of weight, measure, length, and 
time became necessary. 

The simplest division of time, which is noticeable even to the lower 
animals, is that into day and night. This must, of course, have been 
impressed on the minds of our earliest human ancestors, or perhaps 
have been already a conscious reality to the higher apes before they 
commenced to develop a language and to emerge into humanity. The 
division into lunar months required a higher development of intellect 
and the division of the day into hours and minutes, or the establish- 
ment of years and calendar months, based upon the seasons together 
with astronomical observations, necessarily implied a much more 
developed civilization, and could not have taken place until the evo- 
lution of mankind had made considerable headway. 

In order, however, to count the hours, the months, and years, or 
even long previous to that, to count the members of their families, 
the number of their flocks, or of any of their belongings, a system of 
numeration was required by men, and it was but natural that the in- 
dividual would keep tally on his fingers as he counted. Wherever we 
find men, no matter how low they may be in the scale of intellectual 
development, if they can count at all they count in multiples of five, 
the number of fingers of one hand. Beyond this they may vary in 
their system of counting; sometimes counting the fingers of both 
hands, and then commencing over again, or they may also count their 
toes. Many of the savage nations are said to have no words in their 
language for numbers over ten, and can form no ideas or conceptions 
of numbers beyond the number of their fingers, all over ten being 
"many." 

As an example of primitive numeration we may quote the system of 
counting used by the Guinea Indians. These Indians have words for 
only four numbers, corresponding to four fingers, and as they come to 



WEIGHTS AND MEASURES. 37 

the fifth they say "one hand," instead of "five fingers." Six is {( a 
hand and a finger," seven, " a hand and two fingers ;" when they reach 
the tenth finger they say " two hands;" then they count along the toes 
until they reach fifteen or "three hands," and when they come to 
twenty they pass to the next column, as it were, and say, not "four 
hands," but " one man." After this they proceed by a system of twen- 
ties, "two men," "three men," etc.; forty-six being "two men, a 
hand, and a finger." 

The habit of counting in multiples of five, therefore, was ingrafted 
into the human mind by the Omnipotent when He created man by 
development from five-fingered apes. 

The individual human being undergoes, in his embryonic and foetal 
conditions, all the steps of the evolution by which his race became de- 
veloped in the course of ages from the lower organisms to the shape 
of the man-like apes, and, finally, to that of man himself, so that 
his developing body in turn resembles the embryo of fish, reptile, 
bird, quadruped, and ape, but does not stop at any of these stages, 
but progresses to the form of man. So also the intellect of the indi- 
vidual human being, although born with different capacity for develop- 
ment, yet goes through all the stages of mental progress, which has 
characterized the advancement of his race up to his owu position in 
the race, from the speechless ape to the scientist and philosopher of 
to-day. Infants, therefore, whether born in the hut of the Hottentot 
or Papuan, or in the domicile of the most intellectual parents, learn 
instinctively to count on their fingers in multiples of five, and will 
presumably do so to the end of time. 

We may take it for granted that this habit of counting in multiples 
of live is so firmly ingrained into the human mind that nothing will 
ever eradicate it. It is, therefore, somewhat Don Quixotic when 
here and there some have speculated about the introduction of an 
arbitrary system of numeration based on multiples of eight, called 
an " octonary system." Such a system was proposed in the last cen- 
tury, by Swedenborg, the religious visionist and founder of a new 
religious sect, and has lately been referred to again by a well-known 
writer* on pharmaceutical subjects, and the reason stated for this 
desire to revolutionize our methods of numerical notation is the 
insignificant fact that ten can not be successively divided by two until 
brought down to the number one. To say that this fact makes ten an 
inconvenient periodical number for arithmetical notation, is simply an 
assertion based on no foundation of facts, and without any advantage 
to be gained by a change. Moreover, it would be almost, if not entire- 
ly, impossible to learn to think in an octonary system, for if we watch 

*See "A Manual of Weights, Measures, and Specific Gravity," by Profes- 
sor Oscar Oldberg, page i-i. 



38 - THE PRESCRIPTION. 

ives carefully we find ourselves continually using the fingers o: 
our hands as aids in our calculations, not only when we were school 
children, worrying over our lessons in addition, but even when we 
arc mown u;». In fact, an octonary system of numerical notation 
would have been possible only if mankind had ascended or developed 
through the ateles, or four-lingered apes, and became impossible when 
the first primitive man realized that he was created with five fingers on 
each hand. 

Civilized man soon reduced numeration to a definite system, and 
the decimal notation, based on the number of fingers, was at an early 
date of the history of mankind in universal use. Our methods of 
counting and all of our arithmetical calculations are, therefore, decimal. 
It would be desirable that our systems of money and of weights and 
measures should be in accord with our methods of counting and cal- 
culating, and we Americans, who boast of being a practical nation, at 
an early date of our national existence adopted the dollar with its 
subdivision into dimes, cents, and mills, instead of the pounds, shil- 
lings, and pence of our mother country. The English language will 
probably soon be the universal language of commerce, and the dollar 
the universally adopted international coin, and all we need now is to 
bring our systems of weights and of measures of length and capacity 
into accord with our money system, and with the weights, and meas- 
ures of the balance of the nations of earth, so that we may have one 
universal language, and one system of money, of weights, and of meas- 
ures. To meet with cosmopolitan indorsement and adoption, such systems 
m ust be decimal . This is the one essential requirement. If the systems 
of weights and measures stand in some simple relation to each other, 
so much the better; and if the unit from which all are calculated is 
some geographical magnitude, so that the standard could be repro- 
duced if it was ever lost, this would be still better. The only system 
ot weights and measures now known which stands any chance what- 
ever oi becoming international and cosmopolitan is the decimal or 
metric system. When we have an international system of weights 
and measures, with or without an international language, a cosmo- 
politan or international pharmacopoeia becomes a possibility and will 
no doubt soon be a reality. 

Oldberg's Proposed System of Weights axd Measures 

Some years ago Professor Oscar Oldberg proposed a new svstem 
othecaries' weights, which it may be worth while to consider in 
action with this subject of binary Subvllvlslo^, c/.ice tlie entire 

♦Weights, Measures, and Specific Gravity, 1335. 



WEIGHTS AND MEASURES. 39 

system is proposed for the purpose of securing the supposed advan- 
tages of this consecutive division by 2. 
The system proposed is as follows : 

Weight . 

1 troy ounce = 8 drams . 

1 apothecaries' dram = 4 grams. 
1 gram = 16 (new) grains. 

One (new) grain, therefore, is equal to Vi6 gram. 

Measure. 

1 nuidounce = 8fluidrams. 
1 fluidram — 4fluigrams. 
1 fluigram = 16 (new) minims. 

One (new) minim, therefore, is equal to Vi6 fluigram. 
In favor of this system Professor Oldberg says : 

"It will be seen that the above plan involves also a change from 60 to 64 in 
;he number of grains to the dram. Such a change would be of great advan- 
ce, as 60 can not be divided successively by 2 without fractions, more than 
iwice, whereas 64 can be divided into halves, quarters, eighths, sixteenths, 
:hirty- seconds, and sixty -fourths. 

To judge of this alleged desirability, the writer took a popular work 
: m therapeutics and ascertained the proportions of the fractions of 
grains and drams used in giving the doses, and found that of binary 
Tactions V 2 was used nineteen times, and 1/4 three times, and the 
)ther fractions, such as V 8 , y 16 , V321 V&i> not at all* while in the same 
Dages which contained the above fractions, other fractions, such as 
/ft Ve, V10, Vi2> Via V20, V30, V50, Veo, V100, etc., were used altogether 
106 times, or nearly five times as often. 

Taking up a list of formula? of pills, in which, if anywhere, binary 
Tactions would be convenient, it was found that on ten pages taken 
it random 1/2 was used thirty-two times, 1/4 nine times, Vs fourteen 
;imes, Vi6 once, and lower binary fractions not at all, while in the 
same pages other fractions, 1/3, i/ 6 , i/io> 1/20? etc -> were used altogether 
ifty-one times. Since these binary subdivisions are more desirable 
n formulae for pills than elsewhere, on account of the manner of sub- 
lividiug the mass, this would seem to sho.w that the desirability of 
his new system is imaginary, and not based on any actual wants of 
he professions concerned. On the contrary, the frequency of occur- 
•ence of such fractions as Vo> Vio> V20) Vo0> Vioo> etc -> shows that there 
s the unconscious desire to use decimals in preference to other frac- 
ions, and this becomes even clearer when we take into consideration 
mly the binary fractions below V2, for then we find that they were 
ised only twenty-four times, while other fractions below V2> which 
vere _ not obtained by successive subdivision by two, were used 157 
imes. In this enumeration no count was made of whole grains to 






THE PRESCRIPTION. 






rtain what fraction of the dram they represented, but if this had 

i done the argument would be very much stronger against the 

proposed new system. 

The claim, then, that the practice of the professions demands a sys- 
tem capable of binary subdivions, is based on an erroneous impres- 
BioD on the part of the proposer of this new system. And, indeed, 
i ould hardly expect anything different if we consider the develop- 
ment of a knowledge of numbers and their relations in the human 
mind. The most advanced pedagogues of modern times teach us that 
children should be made thoroughly familiar with the number one 
before proceeding to other numbers. When the child is thoroughly 
drilled in all the relations of this number, and all the changes and 
combinations of l, l + 1 = 2, 1 X 1 = !> 1 — 1 = °> 1 -*- 1 = h et c, 
it is then taught that 2 + 1 = 3, 2 + 2 = 4, 2X1=2, 2X2 = 4, 
etc., until it is familiar with all the relations of the number two, 
together with the low r er number already learned. To be able to use 
higher numbers requires a higher grade of intelligence and longer 
education, and 3, 4, 5, 6, 7, 8, 9, and 10 are successively considered 
until the child, step by step, widens its range of thought and ability to 
Use figures. Beyond ten we have essentially a repetition of the multi- 
ples of former numbers, and an amplification of the principles already 
taught. It is, therefore, but natural that children or others with lim- 
ited education should prefer calculations involving mainly the number 
two, but it is an adaptation of ourselves to lower intellectual develop- 
ment when we propose to conform not only our system of numera- 
tion, but also our systems of weights and measures to the capacities 
of the less educated, instead of bringing the masses up to a level in 
which the decimal system is used and preferred. 

It is interesting to observe in this connection that the proposition 
to divide the dram into eighths, sixteenths, thirty-seconds, etc., is 
not original with Professor Oldberg, but that it was formerly used and 
then discarded. 

We have already made reference to the oldest known pharmaco- 
peia, an Egyptian papyrus* found in the Necropolis of Thebes. In 
this work the weights and measures are expressed by a number 
gns, while the numbers are expressed by lines and hooks. The 
unit of this system of weights was probably closely related to the 
Arabic drachma or dirhem, which was equal to about 3 grams, 
but from various considerations it is supposed that this unit was 
double the drachma, or the di-drachma. This unit of weight was sub- 
<li\ ided as is now again proposed by Professor Oldberg, into halves, 
quarters, eighths, sixteenths, thirty-seconds, and sixty-fourths, as is 
u from the symb ols as used in the ancient hieroglyphics : 
page 33. 



WEIGHTS AND MEASURES. 



41 



1 di-drachma. 



% di-drachma. 



Vi6 di-drachma. 




V32 di-drachma. 



Vei di-drachma. 



nnn.i 

riSftii 
nnn.. 

In this work the above fractions are most frequently employed, and 
Vi8 ^ as especially frequently used, because it was believed that a 
medicine, when given in the dose of Vi6 of the di-drachma, was pecul- 
iarly active. 

The unit of measures of capacity was the tenat, which contained 
about 600 cubic centimeters. This measure and its subdivisions were 
expressed as follows : 



Tenat. 



El 



% tenat. 
Y z tenat. 
% tenat. 



3 

+ 
x 



or 



h + x ■■ 
H + y 3 -- 

H + H = 
M + 'A-- 


= 5 /e tenat. 

= % tenat. 
: "/ 12 tenat. 
= % tenat. 


+ + 

+ x 
X3 



The modern sign aa, meaning that equal quantities of several in- 
gredients are to be taken, was expressed by writing a short perpen- 
dicular line to the right of the name of the ingredient, thus : | 

A further peculiarity of this work was that the quantities were 
written with red ink to distinguish them from the other writing. 

It will be seen from this short sketch of the oldest known system 
employing the dram that binary subdivision was in use nearly 3,500 
years ago, and this division was afterwards lost, or discarded, prob- 
ably because experience demonstrated its undesirability. At all 
events, whatever may be the reason of its subsequent disuse, whether 
it was because it was better adapted to a civilization in its infancy, 
and discarded as this civilization grew, thus simply going through the 
process found best adapted to the growing intellect of the child, or 
"whether it was discarded from political or arbitrary motives, the effort 



4> THE PRESCRIPTION. 

10 turn time Lack thirty-five centuries, and to resurrect from among 

the mummies of an almost forgotten race this method of dividing the 

dram, when the world has nearly outgrown the dram altogether, 

u ,tli signal failure, and the system containing the dram 

grains will be replaced, not by one containing a new dram 

ins, but by the system which is based on the gram itself. 

Avoirdupois Weight. 

This system of weights is used for weighing all coarse and heavy 
articles, or for commercial purposes generally. 
The system as generally used in this country is as follows: 

16 ounces = 1 pound. 

100 pounds = 1 hundredweight 

20 hundredweights = lton. * 

Another system, formerly used generally, but now only used in some 

custom house transactions, and, perhaps, in some places at coal mines, 

etc., Is as follows: 

16 ounces = 1 pound. 

28 pounds = 1 quarter. 

4 quarters = 1 hundredweight. 

20 hundredweights = 1 ton. 

And the following terms are also in use : 

100 pounds of grain or flour = 1 cental. 

100 pounds of dry fish = 1 quintal. 

100 pounds of nails = 1 keg. 

196 pounds of flour = 1 barrel. 

200 pounds of pork or beef = 1 barrel. 

280 pounds of salt = 1 barrel. 

240 pounds of lime = 1 cask. 

Many articles, such as grain, dried fruits, seeds, coal, etc., are sold 
by the " bushel," the weight of which in regard to each separate arti- 

ls fixed by law in the various states of the Union. The " bushel " in 

ird to these articles is, therefore, not a measure but a legal weight. 

rmerly the lowest denomination of this system was the grain,. 

which was determined by act of Parliament as follows: " A cubic inch 

"f distilled water, weighed in air by brass weights at the temperature 

_' I\, the barometer being at 30 inches, is equal to 252-458 grains." 
The grain had been in use previous to this law, and this was only 
Legally lixing its value, for, of course, such an odd number and frac- 

i would not otherwise have been fixed as the value of a cubic inch 
of a ater in grains. The pound contains 7,000 such grains. The avoir- 
dupois ounce being the sixteenth part of a pound, or of 7,000 grains, 
contains 437)^ grains. Formerly an avoirdupois dram (one-sixteenth 
of an avoirdupois ounce) was in use, which contained 27 n /32 grains r 
but this dram is obsolete in this country. Ordinarily the smallest 



WEIGHTS AND MEASURES. 4;» 

| denomination of this system of weights is the ounce, less quantities 
I being expressed in fractions of the ounce, or, in medical formulae 
| occasionally in grains. 

The term "avoirdupois" is said to be derived from avoirs, Fr., 
I which means "havings," the ancient name for portable goods, 
I property, or chattels, and poids, Fr., meaning "weight;" and the 
J portable goods themselves were originally designated as avoirdu- 
pois, as in a law enacted during the reign of King Edward III., in the 
year 1353, in which it was decreed that "we will and.establish that one 
weight, one measure, and one yard be throughout the land, and that wool- 
lens and all manner of avoirdupois be weighed." 

Gradually, however, the term lost this meaning, and only two cen- 
turies later, during the reign of King Henry VIII., in the year 1532, 
I another law was promulgated, in which it was ordered that "beef, 
pork, mutton, and veal shall be sold by weight called i haver •dupois .' " It 
will be seen from these two quotations that the term avoirdupois, 
which had been applied in the fourteenth century to the goods them- 
selves, had in the sixteenth century been transferred to the system of 
weights employed for these kinds of goods. 
All of the goods which the pharmacist buys by weight are weighed 
I with avoirdupois weights, and it is very important to remember this, 
J although it is often forgotten. The writer has frequently heard phar- 
macists accusing wholesalers and manufacturers of giving short 
j weight because 1 ounce of quinine did not contain 480 grains, or % 
\ ounce of morphine is not 60 grains, but 54.68 + grains. It is a com- 
| mon error to speak of a " dram vial of morphine," although the vial 
i contains not a dram, but % avoirdupois ounce. Many pharmacists 
j? have only the apothecaries' weights from 1 ounce downwards, as 
used for the prescription scales, and when making their preparations 
I they use the weights of their counter scales, or avoirdupois weights, 
without making allowance for the fact that each avoirdupois ounce is 
42^ grains short in weight, when compared with the apothecaries' 
ounces which should be used. Another common error is, in making- 
preparations, to take 1 ounce of quinine, as purchased, for example, 
to make 480 1-grain quinine pills, thus making each pill about 9 
per cent short weight. 
The terms of the avoirdupois weights are abbreviated as follows: 

The ounce, oz. 

The pound, lb. 

The hundredweight, cwt. 
The ton, T. 

While "oz.,"when standing alone, generally means avoirdupois 
ounce, it is customary, in pharmaceutical works, to write "av. oz.," 
singular, and "av. ozs.," plural, to insure exactness. 



Till: PRESCRIPTION. 

The numbers are expressed in Arabic numerals preceding the signs 
symbols. * 

Troy Weight. 

This system oi weights is used in weighing gold, silver, and jew- 
els and also formerly in philosophical experiments, although for the ; 
latter purpose the metric or decimal system is now universally em- r 
ployed. 

The table is a> follows: 

24 grains = 1 pennyweight. 

20 pennyweights = 1 ounce. 
12 ounces = 1 pound. 

The signs used for these weights are: 

Grain, gr. 

Ounce, oz., or troy oz. 

Pound, lb. 

The term "karat" is also often used in expressing the weight of dia- , 
monds ami other precious stones, and this weight is equivalent to; 
four troy grains. When used to express the fineness of gold the i 
karat means the twenty -fourth part, and " eighteen karat gold," for 
example, means 18 / 2 4 of gold and V24 of base metal. Troy weights are 
used in medicine, although the term "troy ounce " is commonly 
used in medical works and formulae. Really, however, the apothe- 
carles 1 ounce is meant, which is equivalent to the troy ounce but is 
differently subdivided and designated by a different symbol or sign. 
The derivation of the term "troy," as applied to this system of 
bs lias been explained in different ways. One explanation is 
that the ounce of this system was brought from Grand Cairo, in 
, about the time of the crusades, and was first adopted in Troyes, 
d in France, and at one time capital of the old province Cham- 
Another explanation, however, is that Troy novant was an old 
monkish name for London, and that the term " troy weights " is, there- 
fur. , -imply equivalent to saying " London weights." 

In the year 1266, under King Henry III., of England, a law was en- 
acted that 32 grains of wheat from the middle of the ear, well dried, 
igh a pennyweight, of which 20 should go to the ounce. 
•unces made the pound, and the latter, therefore, con- 
rains, but as the pennyweight was afterwards reduced 
QS, the present troy pound contains only 5,760 grains. 
term « ounce" (uncia, ce, f ., Lat; once, Fr., unze, G.), originally 
meant one-twelfth, or one of twelve, and was applied to weights as 
■is to measures of length. The Latin word uncia (probably from 
urn, adj., meaning one and no more, sole, single) means 
relfth of the pound, or ounce, as well as the twelfth of the foot, 



WEIGHTS AND MEASURES. 45 

or inch, and various other derivative words are used in Latin, such as 
semuncia, ce, f., half-ounce, half-inch; sescunx, uncis, m., one and a 
half ounce; quincunx, uncis, m., five ounces, five inches; sexunx, or 
sextunx, uncis, m., six ounces; septunx, uncis, m., seven ounces, or 
seven inches, or seven-twelfths; deunx, uncis, m., eleven-twelfths, 
eleven portions of any weight or measure which is subdivided into 
twelve parts; therefore, eleven ounces, or eleven inches, etc. 

Troy weight is of interest in connection with the subject of the 
prescription, mainly because we receive from it the grain, which 
serves as the unit of the system of apothecaries' weights, which is 
still employed in England and this country, although it has been dis- 
carded by almost all other progressive civilized nations. 

Apothecaries' Weight. 

This system of weights is still in favor in a few countries, as, for in- 
stance, in Russia, England, and tne United States, where it is used by 
physicians, druggists, photographers, and a few others. In all other 
countries of the civilized world it has been supplanted by a superior 
decimal system. 

The table of this system is as follows : 

20 grains = 1 scruple. 

3 scruples = 1 dram. 

8 drams =1 ounce. 
12 ounces = 1 pound. 

It will be noticed that the ounce contains 480 grains, and is, there- 
fore, identical with the troy ounce, for which reason the apothecaries' 
ounce is generally, though perhaps not quite properly, spoken of as 
troy ounce. The pounds of the troy and apothecaries' systems of 
weights are also of equal value, but in prescriptions and in medical 
formula the pound is seldom or never used, and, therefore, it would 
not be improper to omit the last line from the above table. 

The following signs are generally used to express the quantities: 

Grain , gr . 
Scruple, 3. 
Dram, 5 • 
Ounce, 5- 
Pound, ft. 

The grain (granum, i, n.) is the same grain which is the unit of troy 
weight, and was based on the weight of the grain of wheat, as already 
exptained. This weight has no fixed value, and the ^™*£ 
Tary according to the country in which they are manufactured, and in 
consequence many of the little brass weights used in th.s country are 
uncertain and inaccurate. 



HJ THE PRESCRIPTION. 

Lould be remembered that in Latin prescriptions the abbrevia- 
tion used as a sign is always "gr.," and never "grs.," as will be ex- 
plained further on. In English formulae it is customary to write 
I r the plural. 
The scruple (scrupulum, i, n.; formerly also called scrupus, scrupulus f 
riptulus, t, in., or scriplum, scripulum, scriptulum, i, n.) was 
the Lowest unit of weight among the ancient Romans. The word is 
I to be derived from a Latin word, meaning "a small stone," or 
ble, such as might find its way between the sandal and foot, from 
which the meaning " a small objection or difficulty," or scruple, is 

al80 derived. 

The word "scruple M was also used as a measure of time, length, or 
surface, although this use is obsolete. 

Among the ancient Chaldees the scruple signified the i/ioso P art of 
an hour, and in this sense the term was also used by the Jews, Arabs, 
and other Orientals. Later, the scruple was the 1/60 part of an hour, 
and was itself subdivided into " second scruples'' (scrupulum secun- 
dum), from which our modern designation of " seconds " is derived. 

In astronomy the term scruple was also used. For instance, Rees r 
lopanlia describes: "Scruples eclipsed — that part of the moon's 
diameter which enters the shadow, expressed in the same measure in 
which the diameter of the moon is expressed," and the same work 
mentions also li scruples of immersion, scruples of emersion," etc., re- 
ferring to lunar eclipses. 

The origin of the sign for the scruple, 3, is obscure. In a paper by 
Chas. Rice, Ph. D., on the origin of our pharmaceutical signs for 
weights and measures, which was published in New Remedies of July, 
1877, the origin of the scruple sign is thus explained: "The sign [►),. 
which has been in use for a long period, and which we now employ,. 
derives its origin from the Greek letter gamma (y), which is the first 
Utter of the Greek word ypdn/na. {gramma, ce, f.), at present the 
nme or gram of the metric system, but which is really the Greek 
equivalent for the Latin scrupulum. The similarity of the written 

character of the Greek letter gamma, V, when compared with the . 
Bign for the scruple, especially as it is sometimes written, TJr, is 



* 



quite apparent." ^/ 

Another somewhat similar explanation refers to the close resem- 
blance of t]ie written scruple sign, as above, and a slurred written 

the initial letter of the Latin word scrupulum: f+%*fi>/J^ 

While it is possible, in fact probable, that one of these is the 
correct explanation of the origin of the scruple sign as used in medi- 



WEIGHTS AND MEASURES. 47 

cine, yet it is a fact that the sign, as now printed, is of much greater 
antiquity than even Greek civilization. 

It was used, for instance, as a letter in an unknown alphabet, a few 
letters of which were found engraved on a bronze celt found among 
the relics of ancient Rome, as will be seen by reference to a drawing 




of this rude bronze implement. It also formed a character of an 
alphabet which was used in the inscriptions on the curious and valu- 
able relics of the prehistoric American mound-builders , known as the 
Davenport tablets, although in this case there were two central 

strokes instead of one, as is shown in this illustration: ^%. 

In " Atlantis, the Antediluvian World," the author bases an argu- 
ment in favor of his theory of a continent and civilization submerged 
in the Atlantic Ocean on the similarity of some of the words and char- 
acters used in writing among the Indians, Aztecs, and mound-builders 
of America, and among the prehistoric nations of the old world, and 
this sign, now used by us to designate the scruple, was one of these 
characters. 

The fact that the scruple sign, as now used, is a prehistoric charac- 
ter, and occurs in various modifications in several alphabets, suggests 
the possibility that it may have descended to us through succeeding 
civilizations, perhaps from the bronze age, or even from still earlier 
times, but that the true history of its origin can no longer be traced. 

The former use of the word scruple in astronomy as referring to 
phases of the moon's eclipses, and the suggestion of a crescent and 
radius in the shape of the sign as we now use it, is peculiar, though 
probably only a queer coincidence. 

The scruple is rarely used in prescriptions at present, and the prob- 
ability is that this sign will be obsolete even before the remainder of 



4 g THE PRESCRIPTION. 

system of weights has finally been discarded. It is customary 
already to prefer to express all quantities less than a dram in grains, 
rather than in scruples, even when 20 or 40 grains are the desired 
quantities. 

The drachma was a silver coin, the unit of the monetary system of 
ancient Greece. The figures give a fair representation of the two 
sides of the coin in natural size: 





This coin varied somewhat in value in different countries and at 
different times, but was always the Veooo P art °* a talent of silver. 
The Attic talent was worth about $990; the ^ginian, $1,555; the 
Jewish about $1,980. The Attic drachma was worth about 18 cents; 
the JEginian somewhat more. The modern drachma is worth 19 3 /io 
cents. 

The talent was divided into 60 minas, each of which latter contained 
100 drachmas. Really only 96 drachmas were necessary to make a 
mina, but four were added for good measure. The drachma contained 
six oboli, and there were smaller coins called obolus, diabolon, tria- 
bolon or hemi-drachma, and tetrabolion. Two oboli made 1 scruple. 
There were also larger coins, as the di-drachma, tri-drachma, and tetra-- 
drachma. All of these coins were also used as weights, the talent 
weighing about 26-20 kilos. The drachma varied in weight, the aver- 
age weight of five in the British Museum being 60-92 grains each, but 
some of 68-10 grains in weight are also known. 

The word drachma, ce, f., is said to have originally meant " a hand- 
ful" (SpaxMVi from dpatideoSal, to grasp with the hand), because a 
man could grasp six small bars of iron, called oboli. In more modern 
pharmaceutical language a word derived from the same root is used, 
namely dragmis, is, f. (Spayjxis), a small handful, applied to a meas- 
ure for teas, species, etc. 

The Italians, in their language, dropped the harsher sound of " ch " 
and changed the word to " dramma," from which we get our word 
" (Irani." 

Dther explanation of the word drachma is that it is from the 

c drahm, which was derived from two words meaning "away" 

and " to spend," and referred to the amount a traveler would spend in 

a dav. 

The origin of the dram sign, 3, is explained in several ways, the 



WEIGHTS AND MEASURES. 49 

most probable being that it is derived from the Egyptian weights. 
By referring to page 41 it will be noticed that the sign for " one-half" 
tenat is a figure resembling the modern Arabic numeral 3, or the sign 
of the dram, 3 . The Egyptian unit of weight was equivalent to the 
later Greek di-drachma, or two drams. The sign for " one-half" was 
not only used to designate measure, but also to designate weight, and 
then meant half a di-drachma, or a weight which later on became the 
unit of weights among the Greeks, the drachma, and it was but natu- 
ral that the Greeks adopted the Egyptian symbol to express this 
weight, and through them it has descended to our times. This char- 
acter is also one of the letters of the ancient Phoenician, Hebraic, or 
Samaritan alphabet. It is also one of the letters of the Egyptian hie- 
ratic alphabet, which has the same relation to the hieroglyphic alpha- 
bet as our written letters have to the printed characters. The hie- 
ratic character stood for the hieroglyphic "owl," meaning "m," and 
this probably accounts for the figure of the owl on one side of the 
Greek drachma coin. 

The division of the dram into sixty grains, or of the scruple into 
twenty grains, is comparatively modern, as the grain itself only dates 
back to the year 1266. 

The term ounce was applied to the twelfth part of any magnitude, 
whether of length, surface, or capacity, and meant a twelfth part of 
the pound, or an ounce, as well as the twelfth part of a foot, or an 
inch. The ounce (uncia, ce, i.), consisting of eight drams, was one of 
the weights of ancient Greece, and 12% ounces made one mina, about 
equivalent to our pound. The extra half ounce required to make the 
mina was due to the four drachmas given for good measure, as already 
explained. 

Various explanations of the origin of the sign for the ounce, g, have 
been given. It is possible that it was derived from the dram sign by 
adding an extra hook to indicate that it was the next higher denomi- 
nation of weight. Mr. Chas. Rice, Ph. D., in the article already refer- 
red to, gives the following explanation: "The sign for ounce, g, is 
nothing else than the Greek letter g (x) . Its origin admits of two 
explanations. The Greek fluidounce, which was called baphion, or 
oxybaphion (o&fidcpiov, OEVBA&ION), bore a certain relation to 
the solid ounce (it held nearly two ounces) . It was usually denoted 
by the first two letters, written from the right to the left, thus: £0, 
or £0. Finally, the letter ej (x) may have been chosen alone, to denote 
the solid ounce. A much more probable explanation, however, is 
this, that the Greek word for ounce, uggia, pronounced ungia {ovyyia, 
QrrriA), has itself given rise to the sign. Namely, the two central 
g's of the word have been joined to a sort of monogram, which bore 
a great resemblance to the letter 3 (X) , in place of which the smaller 
letter £ (x) was naturally substituted in current handwriting." 



50 THE PRESCRIPTION. 

The signs for the pound, lb. and lb., are simply abbreviations of 
the Latin word libra, ce> f ., a balance, a pound. The sign, lb., without 
the stroke should be used for the avoirdupois pound of sixteen 
ounces; the sign, lb., with the stroke, for the troy and apothecaries' 
pound of twelve ounces each. The stroke in the latter sign represents 
the beam of a balance. Among the Romans the pound was often desig- 
nated ±Jtr also fsEr% or J r% In the central figure of 



ijf P. **> rP* ° r Htb. 



the first of these signs we find a rude effort to picture a beam balance, 
and the two letters stand for " a pound's weight," Libras Pondus. In 
the second sign the attempt to represent a beam balance is unmistak- 
able, and both together serve to explain clearly the origin of the trans- 
verse stroke in lb and its near relative, £. 

Using Only Grain Weights. 

In the construction of many formulae it will be found very conven- 
ient to use only grains, ignoring all higher denominations entirely. 
This saves much calculation, but, on the other hand, necessitates the 
purchase of a set of weights of 1,000 grains and less. Such sets are 
to be had, consisting of 1,000, 500, 200, 200, 100, 50, 20, 20, 10, 5, 2, 2, 
and 1 -grain weights, and fractions of a grain. It is also well to buy a 
number of extra weights of 2,000, 2,000, 5,000, and 10,000 grains each. 

In manufacturing processes the metric system is so far superior in 
convenience to all other systems, that the writer would dislike to go 
back to the old weights. But there are a large number of prepara- 
tions commonly sold which can not well be made by using metric 
weights, unless apothecaries' weights are first translated or transposed 
into grams. Such transpositions, however, introduce chances of error, 
where otherwise none would exist, and under such circumstances it is 
better to use apothecaries' weight. This is the case, for example, in 
making elixirs, in which the teaspoonful or dessertspoonful contains 
a certain portion of a grain or a number of grains of some remedy; 
or in pills made to contain certain quantities in grains. 

If it is desired to make 10 gallons of an elixir containing 2 grains of 
some certain alkaloidal salt in each teaspoonful, it is, of course, nec- 
-ary to ascertain how many teaspoonfuls are contained in this quan- 
. and a tedious calculation is requirad to reduce the 10 gallons to 
minims. Ten gallons is equal to 614,400 minims; the teaspoonful 
equals 75 minims; 10 gallons, therefore, contains 8,190 teaspoonfuls, 
and as each of these is to contain 2 grains, 16,380 grains of the alka- 
loidal salt will be required. It is easier to make out a formula, say- 
30 grains, than to reduce all this again to drams, ounces, and 



WEIGHTS AND MEASURES. 51 

The advantage of using grains alone is clearly appreciated in for- 
mulae for pills, as in this example : 

Compound Cathartic Pills . 

Each pill contains 

Compound extract of colocynth 1 3/ 10 g rg# 

Abstract of jalap 1 g r . 

Mild chloride of mercury 1 gr. 

Gamboge 14 gr . 

Now, if we wish to make pills in large quantities we must adjust 
the formula for the mass to our machine ; if the latter cuts 50 pills, we 
determine the number of boluses to be cut, which will be 2, 4, 8, 
16, 32, 64, 128, or some number obtained by continuous multiplication 
by two, because the mass is made into suitable boluses by subdivid- 
ing into equal halves until the proper sized boluses are obtained. 
Suppose that we wish to make out a formula for 128 boluses, or 6,400 
pills. Multiplying the ingredients of 1 pill by 6,400, we obtain the fol- 
lowing: 

Take of 

Compound extract of colocynth 8,320 grs. 

Abstract of jalap. 6, 400 grs. 

Mild chloride of mercury 6,400 grs. 

Gamboge 1,600 grs. 

Water 1,230 grs . 

We will suppose that a trial shows that 1,230 grains of water will 
just suffice to make a proper mass; we then divide into 128 boluses 
and cut one on the machine. We find that the mass will not roll out 
to 50 pills, but only to 47 pills. We carefully knead in powdered 
licorice root, or other appropriate inert substances, until the mass 
cuts exactly into 50 pills ; if it was necessary to add 5 grains licorice 
root to do this, we add that much for each bolus, or a total of 640 
grains. It may be necessary also to add 30 grains more of water. 
This must be thoroughly worked up together, and also added to the 
formula, which will then be as follows: 

Take of 

Compound extract of colocvnth 8, 320 grs. 

Abstract of jalap 6,400 grs. 

Mild chloride of mercury * • • .6,400 grs. 

Gamboge 1,600 grs. 

Powdered licorice root 640 grs. 

Water 1,260 grs. 

Mix the powders thoroughly; add the water, and make a mass; divide into 
12S boluses, each of which is to be cut into 50 pills on the Xo. 4 machine. 

The numbering of the machines is here supposed to be an arbitrary 
method used in the laboratory to designate the particular machine to 
which the formula was adjusted, and is not a number that means any- 
thing at all outside of the writer's laboratory. The ordinary trade 
designation of pill machines, as five-grain, three-grain, two-grain, etc., 



52 THE PRESCRIPTION. 

is meaningless, and not even true of blue mass, to which these terms 
are supposed to apply. Now, such a formula would be awkward in 
appearance, and it would be difficult to either increase or diminish the 
size of the mass if the quantities were given in pounds, ounces, 

drams, and grains, thus : 

Take of 

Compound extract of colocynth . 1 ft . , 5 ozs . , 2 drs . , 40 grs . 

Abstract of jalap 1 ft., 1 oz., 2 drs., 40 grs. 

Mild chloride of mercury 1 ft., 1 oz., 2 drs., 40 grs. 

Gamboge 3 ozs., 2 drs., 40 grs. 

Powdeied licorice root 1 oz., 2 drs., 40 grs. 

Water ..2fl.ozs., 5 fl.drs. 

Mix, and divide into 6,400 pills. 

It might also be convenient in extemporaneous prescriptions to use 
grains alone, discarding the drams and ounces. This would give us] 
many of the advantages of the metric system, and do away with many 
of the disadvantages of the apothecaries' weights, but, of course, it 
would be better to adopt the metric system altogether . 



Liquid Measure. 

Measures of capacity are of two kinds, measures of liquids and 
measures of dry substances. In medicine dry substances are never 
measured, but always weighed. The unit of capacity for liquids is 
the gallon, and for solids the bushel. 

The table for liquid measure is 

4 gills = 1 pint. 
2 pints = 1 quart. 
4 quarts = 1 gallon. 

The signs of abbreviation are: 

Gill, gi. 
Pint, pt. 
Quart, qt. 
Gallon, gal. 

The barrel (bbl.) is thirty-one and one-half gallons, and the hogs- 
head (McL) is sixty-three gallons, but these are not fixed measures, 
but vary considerably when used for commercial purposes. The 
tierce, hogshead, pipe, butt, and tun are other terms used to desig- 
nate casks used for various kinds of liquids, but have no fixed value 
of capacity. 

Apothecaries' Liquid Measure. 

60 minims = 1 fluidram. 

8 fluidrams = 1 fluidounce. 
16 fluidounces = 1 pint. 

8 pints =1 gallon. 



WEIGHTS AND MEASURES. ^3 

The signs used in prescriptions and formulae are as follows : 

Minim , fl] . 

Fluidram, f3. 
Flnidounce, f 3 . 
Pint, O. 

Gallon, Cong, or C. 

The minim (minimum, i, n., the smallest part), is used for measur- 
ing small quantities of liquids. The sign, TTL, is merely the initial 
letter of the word . 

The sign for the fluidram (fluidrachma, ce, f ., " the measure of a 
dram of water") is simply the sign of the dram, with the letter "f" 
(fluid) prefixed, i%. In English formulae it is often written " fl. dr." 

The sign for fluidounce (fluiduncia, ce, f., " the measure of an 
ounce of water") is the sign of the ounce with an "f" (fluid) pre- 
fixed. In English formulae it is often written " fl. oz." 

The pint is not used in prescriptions, though it is sometimes used 
in formulas. The sign, O, is an abbreviation of the Latin name octa- 
rius, u, m., meaning " an eighth part," referring to the fact that it is 
the eighth part of a gallon. This measure is of modern origin, and 
was not used by the ancients. In English formulae it is customary to 
write "pt." 

The gallon is rarely used in prescriptions or formulas. The sign 
Cong, or C. is an abbreviation of congius, ii, m., the gallon, which, an- 
ciently, was the eighth part of the amphora {amphora, ce, f., a pitcher 
or jug, from the Greek afxcpi-cpipcso^ carry). The word congius is de- 
rived from the Latin word concha, ce, f. (Gr. KoyxoS), tne niussle- 
shell, or conch, which was used as a drinking vessel. In English for- 
mulaswe write "gal.," or "gall." 



Linear Measure. 

The only measures of length, except metric measures, which are 
used in prescriptions are the line, inch, and foot, and occasionally the 
yard. 

Table of Linear Measure. 

12 lines = 1 inch. 

12 inches = 1 foot. 

3 feet = 1 yard. 

The signs are as follows : 

Line, '" 
Inch, " or in. 
Foot, ' or ft. 
Yard, yd. 

The line and inch are sometimes used in designating the sizes of 



54: THE PRESCRIPTION. 

plasters, etc., and the foot and yard in ordering bandages, but all of 
them are but rarely employed in prescriptions. 

Incidentally, it may be remarked that the division of the foot into 
inches and lines (or into twelfths and one-hundred-and-forty-fourths) 
inconvenient, that in civil engineering, surveying, and for simi- 
lar purposes, the foot is often divided into tenths and hundredths, 
showing here also the urgent necessity of abandoning the old and 
inconvenient forms, and substituting therefor an advanced and ra- 
tional decimal system of measures. This division of the foot into 
tenths and hundredths is merely a make -shift until the metric system 
is finally adopted in this country. 

Necessity of ax International Decimal System of Weights. 

With the advancement of civilization and its attendant progress in 
regard to commerce, and especially since rapid communication by 
railroads, steamboats, and telegraphs has almost annihilated distance 
and time, and has brought continents and nations much nearer to each 
other, so that our world is now only a very small globe indeed, it has 
become more desirable that there should be one cosmopolitan or inter- 
national system of weights and measures, as w.ell as of money, pos- 
tal service, language, etc. 

This world is becoming altogether too small to make it possible to 
continue using so many different systems of money and of weights 
and measures as are now in use, and it is altogether probable that 
one system of each will eventually displace all others, and it is, there- 
fore, of great importance to determine which one this is likely to be, 
and then to aid in its introduction. 

A.S already stated in previous pages, the coming international mone- 
tary system must be decimal, and dollars, climes, and cents will prob- 
ably soon be used all over the world; so also, the system of weights 
and measures must be decimal, and the first used decimal system has 
the advantage in regard to chances of universal adoption. It is safe 
to say that if any nation had used for centuries a system employing 
the grain, perhaps, as follows : 

10 grains = 1 scruple, 
10 scruples = 1 dram, 
10 drams =1 ounce, 
10 ounces = 1 pound, etc., 

then, when steamboats and locomotives brought our antipodes within 
a few days' traveling distance, and the telegraph enabled us to read in 
the morning's paper what had occurred on the other side of the world 
at noon there of the same day, that such a decimal system might have 
had a fair chance of general adoption. 



WEIGHTS AXD MEASURES. - 55 

But no decimal system including the grain was in use, and when 
the desirability of an international system of weights became felt, the 
only decimal system of weights and measures then known was adopted 
by one nation after another, until now but few nations exist which do 
not employ it. This system is the decimal or metric system. 

Professor Oscar Oldberg says: "This system was not the work of 
any one mind, nor of any one nation. It was the legitimate offspring 
of the times. In its conception and development, as in its steadily 
increasing domain, no nation can claim it as its own; but France had 
the honor of being the first to adopt it. It has continued to spread 
until adopted by more than one-half of the inhabitants of the civilized 
world. It is obligatory by law in the following countries: Argentine 
Confederation, Austro-Hungary, Belgium, Brazil, British India, Chili, 
Costa Rica, Ecuador, Egypt, Erance, French Colonies, Germany, 
Greece, Guatemala, Italy, Mexico, Netherlands, Dutch Colonies, Nor- 
way, Peru, Portugal, Roumania, Spain, Spanish Colonies, Sweden, 
Switzerland, Turkey, United States of Columbia, Uruguay, and Ven- 
ezuela. The aggregate population of these countries is about 500,- 
000,000. 

u The metric system is in part obligatory in Denmark and its colon- 
ies; population about 2,000,000. 

" It is permissive in Great Britain, the British Colonies, and the 
United States, with an aggregate population of about 100,000,000. 

" The only country in which the metric system is not permitted for 
commercial transactions is Russia, with a population (including its 
dependencies) of about 90,000,000. For scientific purposes, the met- 
ric system is in universal use. * * * 

"The metric system is now used in the pharmacopoeias of Austria, 
Belgium, Denmark, Erance, Germany, Greece, Mexico, Norway, Rus- 
sia, Sweden, Switzerland, and the United States. In the last named 
Pharmacopoeia, however, the troy grain is also used in part. 

"Most of the best works on chemistry, pharmacy, and materia 
medica in all languages now use the metric system." f 

In the light of these facts, can any one doubt which system of 
weights and measures is destined to be the successor of all others, and 
to become cosmopolitan? and must not all efforts to retard the con- 
summation of this final result appear as the futile effort of short- 
sighted obstructionists who vainly attempt to stem the on-rushing 
tide of human progress and civilization? 

We may rest assured that whether we indivicluaUy favor or oppose 
the use of the metric system, its intrinsic merits, as well as its adven- 
titious advantages, are such that it will continue to spread until it is 
the system of the world, by which all mankind « from Greenland's icy 

tWeights, Measures, and Specific Gravity, by Oscar Oldberg, Pharm. D., 
1885. 



56 THE PRESCRIPTION. 






mountains to India's coral strand " will weigh and measure. Our op- 
position may delay this, but will not prevent it. 

It is true that there are some who think that the metric system may 
progress until it is finally adopted for all purposes, except for the par- 
ticular purpose for which they themselves use it. Thus, there are 
photographers who write in their journals in favor of troy weights for 
photographers; or pharmacists or physicians who admit the superi- 
ority of the metric system of weights and measures for all other pur- 
poses, except for medicine and pharmacy ', thinking, in their short-sight- 
edness, that medicine and pharmacy can stand still while all the world 
else progresses. But no branch of human knowledge or thought can 
stand still. The Genius of the Age urges it on, and it must progress 
with the other branches of science or perish altogether. 

In pharmacy and medicine there can be no rest or cessation of 
advancement until there is one universal pharmacopoeia, with one uni- 
versal system of weights and measures, so that a prescription written 
anywhere may be compounded alike in all the pharmacies of the world ; 
and individual physicians or pharmacists who can not, or will not, 
keep pace with the advancing strides of their professions, will simply 
be dealt with according to the fixed laws which result in the " sur- 
vival of the fittest." 

The evidently predestined universal use of the metric system of 
weights and measures for all purposes, including medicine and phar- 
macy, makes it desirable that we should consider it carefully, so thai 
we, each one of us, may be able to use it readily, and thus aid, rathei 
than obstruct, the evident tendencies of the times. 

The Metric System. 

Several decimal systems of weights and measures have been 
proposed, but none of them ever came into use except the metric 
system. This system is so called because it is based upon the meter, 
from the Greek, /uerpov, measure. 

It is immaterial what forms the unit of any system, and an 
arbitrary weight, as the grain of wheat, which gave rise to our grain 
weight, will answer as well as any other, provided it is afterwards 
defined by law to become of fixed and absolute value. So the meter 
might originally have been an arbitrary length without affecting the 
value of the system thereby. But it was deemed advisable to make 
the meter of such a definite value that if all traces of these weights 
and measures were to be annihilated the meter could be readily re- 
placed. 

The meter is the one-ten-millionth part of the distance from the 
earth's equator to the pole, and may, of course, be calculated again at 






WEIGHTS AND MEASURES. 57 

any time, if necessary. The standard meter is made of platinum, and 
is, therefore, not corrodible; it is kept in Paris, iu a fire-proof building, 
and as its length varies with the temperature, it must be measured at 
0° C. According to this standard the standard weights and measures 
of all other countries have been prepared so that the meter may be 
the same all over the world. 

From the meter, which is the unit of length, all other units, as of 
measures of surface, of cubic contents, and of weights, have been ob- 
tained. 

The meter is equivalent to 39-37+ inches, or, approximately, to i0 
inches. It is the unit for measures of length; used like our yard. 

A square having sides often meters, or 100 square meters, is called 
Are, and is the unit of measures of surface, as of land. This term is 
used like our word acre. 

A cube, each of whose faces is one-tenth of a meter square (one 
cubic decimeter), is called Liter, and is the unit for measures of ca- 
pacity. It is a little more than one quart. 

A cube, each face of which is one one-hundredth of a meter square, 
or one cubic centimeter, is equal to the thousandth part of a liter; and 
the weight of one cubic centimeter of pure distilled water, weighed in 
vacuo, with water at its greatest density (4° C. or 39*2° F.) is a gram, 
which is the unit of weight. 

The other denominations of the metric system are named by prefix- 
ing Greek syllables to express the upward scale, and Latin syllables 
to express the downward scale, or decimal fractions, thus: 
Deca, from dt/ca, deca, ten. 
Hecto, from ticarov, hecaton, hundred. 
Kilo, from ^z'Azoz, kilioi, thousand. 
[ Myria, from fivpi&$> myrias, ten thousand, or many. 

!Deci, from decima, ce, f ., the tenth part. 
Centi, from centesima, ce, f ., the hundredth part. 
Milli, from millesima, ce, f ., the thousandth part. 
In waiting any quantity, however, it is not customary to w T rite the 
names of these different denominations, but to write them in the form 
of whole numbers and fractions, in a similar manner as we write dol- 
lars and cents; we write $1.15, and not $1, 1 dime, and 5 cents. 

Applying the prefixes to the gram, we have the following denomina- 
tions : 

Pronounced. 

Myriagram , or 10 kilos 

Kilogram , or kilo 

Hectogram 

Decagram 

<5ram 

Decigram 

Centigram 

Milligram 



Greek 



D,00O- 

1,000' 


Written, 
grams, or 
grams, or 


10 kilos. 
1 kilo. 


100* grams. 
10- grams, 
1- gram. 
0-1 gram. 
0-01 gram. 
0-001 gram. 







THE PRESCRIPTION. 

Different opinions have been held in regard to the proper method of 
word "gram," many preferring "gramme" to the ordi- 
gliso method of spelling it, on the ground that there is not 
sufficient difference between gram and grain. But, as the word is not 
lied in full in prescriptions, and the abbreviation Gm., with a capi- 
tal (i and a heavy line underneath, is generally used ; together with 
Arabic numerals, it probably makes little difference how the word is- 
Bpelled. If any one has not formed a habit of writing it in either way 
it might, perhaps, be advisable to write "gramme," as long as the old 
ins is still in use. 
It Is not customary in this country to use the ascending terms, ex- 
i the kilogram. We prefer to say u one hundred grams" rather 
than " one hectogram." The word kilogram is used similarly as the 
term pound is ordinarily employed. It is the unit for weighing com- 
mercial quantities of heavier goods, which are sold by weight. Crude 
drug 4d by the kilogram (abbreviated to "kilo"). A bale of 

cinchona, for instance, contains from sixty to one hundred "kilos," 
or, approximately, twice as many pounds, the kilo being equal to 
avoirdupois pounds. 

above prefixes are used with other metric terms as well; with 
the meter, for example, we have myriameter, kilometer (used as a 
unit as we ordinarily use the mile), hectometer, decameter, meter, 
decimeter, centimeter, and millimeter. 

In expressing quantities of weight or measure in prescriptions, we 
use only the gram and the cubic centimeter as units, and express all 
quantities, either as whole numbers to express one or more than one 
unit of each kind, or as fractions to express quantities less than one 
unit of a kind. When it is necessary to express linear measures in 
prescriptions, the meter and its subdivisions are used. 
The following abbreviations are occasionally employed: 

Meter, M. orm. 

Decimeter, Dm. or dm. 
Centimeter, Cm. or cm. 
Millimeter, Mm. or mm. 

In microscopical measurements the one-thousandth part of a milli- 
3 often used as the unit of measurements, and is called micro- 

\s an abbreviation, the Greek letter m is used, thus: ,«. 
following abbreviations for weights have been used in pre- 
ptions: 

Gram, G., Gm., or Gm. 

Decigram, Dg. ov dgm. — 
Centigram, Cg. ov cgm. 
Milligram, J\Jg. or mgm. 

•ions for the subdivisions of the gram are, however, 
employed, and errors are less likely to occur if we discard them 






WEIGHTS AXD MEASURES. 

altogether and express these quantities as fractions of the gram: or 
if we use these terms, we should write them out in full. 

Of liquid measures only the cubic centimeter is used in prescriptions ■ 
abbreviated C.c. In formulae for larger quantities the liter is sonic- 
times used. The liter is written L. 

In writing any quantity in metric terms in a prescription, we write 
the name of the quantity, preceded by the number in Arabic characters, 
as in the following example : 

R— Morphinae sulphatis, 0*10 Gm. 

Quininae sulphatis, 2-50 Gm. 

Acidi sulphurici diluti, q. s. 

Tincturae cardamom! compositae, 10-00 C.c. 

Syrupi sacchari, 25*00 C.c. 

Aquae purae , 165 • 00 C . c . 

Misce et signa: Tablespoonful three times a day. 

When less than one gram or one cubic centimeter is taken the deci- 
mal point is emphasized by placing a zero in the unit place, as above. 
To avoid all errors from any misplaced or omitted decimal point, it 
has been suggested to use a decimal line, thus : 

R— Opii pulveris, 0j25Gm. 

Quininae sulphatis, 5 1 00 Gm. 

Extracti gentianae, q. s. 
Fiat massa et divide in pilulas XXX. 
S.: One pill night and morning. 

Still another plan suggested is to rule the prescription blanks as 
for dollars and cents, only that we must have four spaces instead of 
two for the fractions, and that the denominations of the fractious are 
printed above the columns as in the following example : 



Grams. 

R — Strychninae sulphatis, 

Extracti belladonnae, 

Extracti colocynthidis compositi, 7 

Misce et divide in pilulas L. 
Signa: One pill at bedtime. 

In the above examples the abbreviation Gm. for gram can not be 
mistaken for the abbreviation gr. for grains, because the latter is 
always written first with a small g, and with the number following in 
Roman numerals. 

In European countries it is customary in dispensing to weigh liquids 
as well as solids, and only the gram and its fractions are used. This 
is so thoroughly understood that no abbreviation for the gram is nec- 
essary at all and only numbers are written. 

R— Magnesii sulphatis, 25* 

Extracti sennae fluidi, 10- 

Syrupi zingiberis, 15* 

Aquae, q. s. ad 200* 

Misce. Signa: Tablespoonful every two hours. 



be 


bi 


b£ 


- 


O 


3 





5 




2 







5 








GO THE PRESCRIPTION. 

If we could have the general agreement in this country that all sol- 
ids arc to be dispensed byiveight and all liquids by measure, this last plan 
would be the plainest, and, therefore, best. We would read grams for 
solids and cubic centimeters for liquids and dispense accordingly. 

When any one wishes to adopt the metric system for use in prescrib- 
ing, he should attempt to think in metric terms as soon as possible, 
because a mere transposition of the quantities into metric terms after 
having been thought and calculated in the old apothecaries' terms is 
Dot a proper use of the newer and better system, any more than a man 
can be said to write in the English language who first writes an article 
in a foreign language, and then laboriously translates into English. 
His English composition will not only be awkward in style, but it will 
betray its origin in its idiomatic construction, and will merely be Ger- 
man, French, etc., as the case may be, clothed in English garb. So, 
also, we often see metric prescriptions in different medical works 
which show unmistakable signs of having been originally constructed 
with grains, drams, and ounces. 

There are different methods of acquiring the habit of thinking in 
metric terms, some of which appear to involve much unnecessary 
labor, and retard, rather than facilitate, the introduction of the deci- 
mal system. We may safely assert that any plan which gives rules for 
the exact conversion of apothecaries' weights into grams will not suc- 
ceed in teaching any one to use the metric system properly, and will 
make the acquisition of an ability to write metric prescriptions flu- 
ently appear as a formidable undertaking, when, in reality, it is ex- 
ceedingly simple and easy. 

Rules for converting grains into grams, or vice versa, with mathe- 
matical exactness are superfluous under all ordinary circumstances, 
for when exactness is really desirable it can be better secured by re- 
ferring to tables of equivalent quantities, and when it is not neces- 
sary, these rules are too cumbersome and tedious for practical use. 

If rules for conversion are used at all, they should be so simple that 
they can be used mentally and instantly. 

The easiest and quickest method probably is to simply memorize 
the equivalent values of *a number of the more familiar quantities, and 
then from them calculate other quantities that we may meet with. We 
commence with a small list, and go over it until all proportions are 
perfectly fixed in the memory. Then, we may enlarge the table and 
memorize this also. For example, we memorize some such tables as 
the following : 

Equivalents of Linear Measure. 

1 line = about 2 millimeters, or 0-002 meters. 
1 inch = about 25 millimeters, or 0-025 meters. 
1 foot = about 30 centimeters, or 0-30 meters. 
1 yard = about 90 centimeters, or 0-90 meters. 



WEIGHTS AND MEASURES. 



61 



To realize this relationship, it will be well to carefully compare the 
scale of one decimeter and its subdivisions with the scale of four 
inches and its subdivsions in the accompanying figure. 



ENGLISH INCHES. 

2 



J_ 



_ 



_L 



_I_ 



J_ 



J_ 



_L 



J_ 



I ; 1 ) 1 M 1 1 J 1 1 1 1 ( ' i I ! 1 '. i i i i ; ! 1 1 1 ! : . . i ■ ; . i : i 1 1 1 ) ; i i M ; 1 1 1 , ; i ; j 1 1 1 1 i 1 1 1 1 1 1 1 f 1 1 1 j i f 



2 3 * 5" 6 7 6 

1 DECIMETER = 10 CENTIMETERS = 100 MILLIMETERS . 



Next we try to realize and memorize measures of capacity. The 
scale representing one decimeter in the above figure serves to con- 
struct a measure of capacity. A cubic decimeter is one liter, as al- 
ready explained. 

Equivalents of Fluid Measure. 

15 minims = about 1 cubic centimeter. 
1 fluidram = about 4 cubic centimeters. 
1 fluidounce = about 30 cubic centimeters. 
1 pint = about 0-5 liter, or 500 cubic centimeters. 

1 quart = about 1 liter, or 1,000 cubic centimeters-; 

Equivalents of Weight. 

1 grain = about 0-06 gram, or G centigrams. 

15 grains -= about 1 gram. 

1 dram = about 4 grams. 

1 troy ounce = about 30 grams. 

For use in learning to construct a metric prescription, it becomes 
necessary to adopt some easy rules for conversion from apothecaries' 
to metric weights. The simplest method is as follows : 

Multiply ounces by 30 to get the number of grams. Multiply drams by 
4 to get the number of grams. When there are less than 60 grains 
divide by 15 to ascertain the number of grams. If there is a remain- 
der, or if the number of grains is less than 16, we may reduce to 
fractions of a gram, as follows: 

Assume the gram (written l'OO Gm.) to be equal to 15 or 16 grains. 
To convert any number of grains less than 1 6 into centigrams, think 
what fraction that number is of 15 or 16, as may be most convenient, and 
then take that fractional part of I'OO gram to express the metric equiva- 
lent, ignoring fractions beyond the second decimal place. 

The following will make this clear : 

1 grain = Vie of 16 grains ; Vie of l'OO gram = 0-06 gram. 

2 grains = Vg of 16 |rains ; Vs of l'OO gram = 0-12 gram. 

3 grains = 1/5 of 15 grains; Vs of l'OO gram = 0-20 gram. 

4 grains = y\ of 16 grains; J/ 4 of l'OO gram = 0-25 gram. 

5 grains = Vs of 15 grains ; Vs of l'OO gram = 0-33 gram. 

6 grains = 2/? of 15 grains ; «/« of TOO gram = 0-40 gram. 
8grains = V2 of 16 grains; V 2 of TOO gram = 0-50 gram. 
9 grains = 3/ 5 of 15 grains; 3/ 3 of l'OO gram = 0;60 gram. 

10 grains = 2/ 3 of 15 grains ; Vz of l'OO gram = 0-66 giam. 
12 grains = 3/i of 16 grains; B/ 4 of l'OO gram = 0"<5 gram. 



THE PRESCRIPTION. 

Or we remember that a grain equals 0-06 gram, and multiply this by 
the total number of -rains. For instance 20 grains = 20 X 0*06 gram, 
or L-20 grams; 86 grains = 36 X 0- 06 gram, or 2-10 grams. 

In some parts of the country the custom still prevails of using the 
" hit M in Btating money values— eight bits making a dollar, and the bit 
being, therefore, 12)^ cents, written 0.12% dollars; "two bits," "four 
" and "six bits" are $0.25, $0.50, and $0.75 respectively. The 
uneven number of bits are rarely employed, but three bits would be 
nve bits $0.62%, and seven bits $0.87%. To any one familiar 
with these "bits," the conversion of grains to grams offers no difii- 
enlty. Two grains equals 0-12%, or 0-125 grams, which fraction is 
written like one bit. Therefore, divide the number of grains by 2> and 
write the fraction of a dollar for that number of bits. For instance, to 
convert 12 grains: 12h-2 = 6; six bits is $0.75; omit the dollar sign 
and substitute the gram sign and it is done; to convert 9 grains: 
2 = 4 '.j : 1)4 bits is $0.56. Or, when the number of grains is un- 
even, we may divide by 2, ignoring the fraction, taking the value of 
that number of bits and adding 6 cents for the odd grain; to convert 
5 -rains: 5-r-2 = 2; "two bits" is $0.25, to which we acid G cents, 
Which makes $0.31; therefore 0-31 gram, or, for appearance's sake, 
0-30 gram. 

While the above equivalents and rules for the conversion of 
apothecaries' weights into metric quantities are only approximately 
correct, they are sufficiently accurate for all practical purposes; and 
as they can be used mentally, they may serve a valuable purpose dur- 
ing the transition period, w T hile the physician still thinks in the old 
terms, but writes in the new. A short time of practice, however, will 
soon enable him to use the metric terms without any mental reference 
to grains. When we use metric terms we should try to use whole or 
fractional numbers that are multiples of five or ten as far as possible, 
partly because the decimal prescription looks better when thus writ- 
ten, and partly because the weights are made according to this plan 
and the graduates are engraved with gradations of five and ten cubic 
centimeters. Besides, the bottles made for metric prescriptions con- 
tain 10, 25, 50, 75, 100, 150, 200, 250, etc., cubic centimeters, and these 
bottles should be filled just as it is the aim of the physician to pre- 
scribe a quantity of fluid that may about fill the )^, 1, 2, 4, and 6-ounce 
vials. It does not look any better to dispense 180 cubic centimeters 
in a 200-cubic-centimeter vial than to dispense 5 fluidounces in a 
6-ounce vial. 

Suppose, then, that we are beginners in the use of the metric system, 
and must still construct our prescriptions according to the old plan, 
or with quantities in apothecaries' weights, and that we wish to pre- 
scribe the following: 



WEIGHTS AND MEASURE8. 63 

R— Copaibae, fji. 

Acaciae pulv., 

Aquae, aaq. s. ut ft. enmls. fsv. 
Adde 

Spir. lavandul. comp., f^ii. 

Syr. tolutan., f 5i. 

M. S.: Tablespoonful every three hours. 

We write out the whole of the formula, only omitting the quanti- 
ties, thus: 

R— Copaibae, 

Acaciaepulv., 

Aquae, aaq. s. ut ft. emuls. 
Adde 

Spir. lavandul. comp., 

Syr. tolutan., 

M.S.: Tablespoonful every three hours. 

The emulsion we wish to prescribe, as above, is to measure about 
6 fluidounces; 6 fluidounces, however, are equal to about 6X 30, or 180 
cubic centimeters. The next size of metric bottle is one of 200 cubic 
centimeter capacity, and we determine to fill that. One-sixth of the 
emulsion is to be copaiba; one-sixth of 200 cubic centimeters is 33 
cubic centimeters, but, as already explained, we prefer a multiple of 
5, and, therefore, write 35 cubic centimeters. This is to be mixed with 
acacia and water to make 5 fluidounces of emulsion; 5X 30 cubic centi- 
meters = 150 cubic centimeters. To this is to be added 2 fluidrams 
of compound spirit of lavender; 2X4 cubic centimeters = 8 cubic 
centimeters, but as the whole mixture is somewhat increased, we in- 
crease the quantity of the spirit to an even decimal number — 10 cubic 
centimeters. This added to the 150 cubic centimeters of emulsion is 
160 cubic centimeters, and to make the desired 200 cubic centimeters 
we need 40 cubic centimeters, which is the measure we take of the 
syrup. This is, of course, a mental calculation, and requires scarcely 
as much time as it takes to read it, and then we write down the quanti- 
ties after the names of the ingredients. Our prescription will then 
appear as follows : 

R— Copaibae , 35 C . c . 

Acaciae pulv., 

Aquae, aa q. s. ut ft. emuls. 150 C.c. 
Adde 

Spir. lavandul. comp., 10 C.c. 

Syr. tolutan., 40 C.c. 

M. S. : Tablespoonful every three hours. 

We carefully look this over to see that we have made no error, and 
then the perscription is done. In a few weeks we will become so 
familiar with metric terms that we can write the prescription without 
first thinking it out in apothecaries' weights and measures, although, 
for safety's sake, we may prefer for a time to verify our metric pre- 



54 THE PRESCRIPTION. 






Bcriptiona by mentally transposing to the old and more familiar quan- 
tities. 

When once we have acquired the ability to use the metric system, 
we can not help but become charmed with its scientific simplicity and 
beauty, and will not desire to return to the use of the old system. 
Those who are best and alone able to judge regarding the compara- 
tive merits of the two systems— namely, those who have used and 
thought In both systems— are unanimous in their preference for the 
decimal metric system. The opposition to the metric system comes 
from those who either have never studied the system at all, owing to 
prejudice or laziness to devote a little time and trouble, and who are, 
therefore, really incompetent to form any opinion at all on the sub- 
ject, and ought to have the good grace to acknowledge this, or from 
those who have devoted some time to the study of the system, but 
have never acquired the ability to think in this system. To the latter 
class it then necessarily appears as a cumbersome system, and as one 
that involves chances for errors that would be avoided by the use of 
grain weights. 

It should, therefore, be the aim as soon as possible to learn the 
metric doses of remedies and to think in metric terms, in order that 
the system may be used in a proper manner in prescribing, and it will 
prove profitable to devote an hour a day for a week or two to tak- 
ing the prescriptions on a druggist's file and changing them to metric 
prescriptions, as above explained. 

As it is the custom in this country to give medicines to the patient 
in measured doses (teaspoonful, etc.), the calculations of doses and 
of total quantities to be dispensed are based on the measures of the 
liquid ingredients, and not on their weights. To prescribe and dis- 
pense by weight would make it necessary for the physician to remem- 
ber the specific gravity of every fluid extract, tincture, solution, syrup, 
etc., and to calculate the weight of each such ingredient, so that he 
may obtain the desired total volume of medicine. This involves too 
much trouble and too many chances for errors in prescribing, so that 
it is to be hoped that both the pharmaceutical and medical professions 
will insist on prescribing and dispensing solids by weight and liquids 
by measure. 

Under certain circumstances it may be desirable to use exact equiv- 
alents, and then it may be remembered that the gram equals 15-432+ 
grains. This number is easily memorized by writing the figures in 
descending order, beginning with 5, then 4, 3, 2, and when 1 is reached 
writing this before the 5 instead of after the 2, and then placing the 
decimal point after the 5. 

The second column of the following table gives exact metric equiv- 
alents for the apothecaries 1 weights in the first column : 



WEIGHTS AND MEASURES. 



65 



Conversion of Apothecaries' Weight to Metric Weight. 



Apothecaries' Metric 

weight. weight. 

1/60 grain 0-001 

i/so " 0-002 

1/20 " 0-003 

VlO " 0-006 

1/8 " 0-008 

1/G " 0-011 

1/5 " 0-013 

1/4 " 0-016 

1/3 " 0-021 

1/2 " 0-032 

2/3 '* 0-043 

3/4 " 0-048 

1 " 0-065 

2 grains 0-13 

3 •• 0-19 

4 " 0-26 

5 " 0-32 

6 " 0-39 

7 " 0-45 

0-52 

0-58 

Oss) 0'65 

0-78 

0-91 

0-97 

104 

1-17 

Oi) 1-30 

1-53 

(3ss) 1-94 

2-33 

(9ii) 2-59 

311 

Oiiss) 3-24 

(3i) 3-89 



9 
10 
12 
14 
15 
16 
18 
20 
24 
30 
36 
40 
48 
50 
60 



grains ( 

( 
( 
( 

( 



Siv) .. 
3iss).. 
Bv)... 
3ii>... 

3iiss). 



Apothecaries' Metric 

weight. weight. 

5-18 

, 5-83 

6-48 

, 7-77 

9-72 

10-36 

11-66 

12-96 

„SS) 15-53 

drams ( 3 v) 19-44 

3vss) 21-39 

3vi) 23-33 

3vii) 27-22 

§i) 31-10 

Six) 34*99 

3x) 38-88 

3iss) 46-66 

3xiv) 54-43 

3ii) 62-21 

3xviii) 69-98 

~iiss) 77-76 

ounces ( § iii) 93*31 

giiiss) 108-86 

5iv) 124-42 

Sivssj 139-97 

l\) 155-62 

gvss) 171-07 

5vi) 186-62 

>V2 " (Sviss) 202-18 

§vii) 217'73 

Sviii) 248-83 

gix) 279-94 

10 " (£x) 311-04 

11 " (5xi) 342-14 

12 " (Jxiiorlbi) 373*25 



80 
90 
100 
120 
150 
160 
180 
200 
240 

5 

51/2 

6 

7 



10 
12 
14 
16 
18 
20 

3 

3 1/2 

4 

41/2 

5 

5V2 



(3iii) 

(V 



Iii the second column of the following table are given approximate 
equivalents in grains for the metric quantities of the first column ; the 
third column is in drams and apothecaries' ounces : 



Conversion of Grams to Apothecaries 1 Weight, 



Metric 

o-ooi 

0-002 

0-003 

0-004 

0-005 

0-006 

0-008 

0-01 

0-02 

0-03 

0-04 

0-06 

0-08 

0-10 

0-15 

0-20 

0-25 

0-40 

0-50 

0-75 

1-00 

1-50 



weight, 
gram — 



Apothecaries' weight. 

i/6o gram 

Vao " 

1/20 " 
Vl5 " 
Vl2 " 

VlO " 

1/8 " 

1/6 " 

1/3 " 

1/2 " 

2/3 " 



grams. 



1 

11/3 grains. 

12/3 " 
21/2 " 

3 

4 

6 

8 
12 
16 
23 



(jO THE PRESCRIPTION. 

Metric weight. Apothecaries' weight. 
2-00 grams 31 grams. 1/2 dram. 



7 



11 



500 



38 

46 " « 

j «' 62 " 1 dram. 



2-50 



5 " << 

,; ♦< 92 " IV2 drams 



108 



— 123 " 2 drams 

g - 139 



jo " 154 " 2 1/2 drams 



170 



** 185 " 3 drams 

13 " 200 



it ♦< 216 " 3 1/2 drams 

15 " 232 



10 " 247 " 4 drams 

17 •' 262 

W " 278 

19 " • 293 



20 " 309 " 5 drams 

21 " 324 " 



22 " 340 " 

23 " 355 " 6 drams 

24 " 370 " 

25 " 386 " 6 1/2 drams 

26 " 401 " 

27 " 417 " 7 drams 

28 " 432 " 

29 " 448 " 71/2 drams 

30 " 463 " 

35 " 540 " 9 drams 

40 " 617 '• 

45 " 694 ' ' Hi/2 drams 

50 " 772 " 13 

60 " 927 " 151/2 " 

70 " 1,080 " 18 

80 " 1,235 " 201/2 " 

90 " 1,389 " 23 

100 '• 1,543 " 251/2 '* 

125 '" 1,929 " 4 ounces 

150 " 2,315 " 381/2 drams. 

175 " 2,701 " 45 

200 " 3,086 ■« 50 " 

225 " 3,472 " 58 

250 " 3,858 " 8 ounces. 

275 " 4,244 " 70V 2 drams. 

300 " 4,630 '* 77 

325 " 5,015 " 831/2 " 

350 " 5,401 " 90 

3 *° " 5,787 " 12 ounces, 

*S° " 6,173 " 13 

Jg ;; 6,559 " 131/2 •• 

fi>2 6,944 " 141/2 " 

7,330 •« 15 



.7,716 " • 16 



In all the above rules and tables we may substitute respectively 
cubic centimeter for gram, minim for grain, fluidram for dram, and fluid- 
ounce for ounce, when the quantities refer to fluids. Incidentally it 
may be mentioned that Professor Oscar Oldberg proposed the word 
"fluigram " instead of cubic centimeter, as being simpler and show- 
ing the relation to the gram more readily. On the other hand, the 
term cubic centimeter conveys a clear idea of the actual volume of 
the liquid. The term " fluigram " has not been generally accepted. 

Reference has frequently been made in journals to the improper use 



WEIGHTS AND MEASURES. 67 

of the decimal point in the metric prescriptions. We may avoid 
chances for error and misunderstanding by observing the following 
rule: 

In prescriptions never use the decimal point except to designate the gram 
.and its decimal fractions, as any other use is liable to lead to mistakes. 

It is wrong, for instance, to write "0-2 centigram," because many 
readers accustomed to using the metric system, would be apt to over- 
look the word centigram and read the above as "0-2 gram," which it 
would be if the figures stood alone without any designation. The 
above should be written " 0*002 gram," or "0*002 Gm.," or "2 milli- 
grams." 

It is perfectly proper to use whole numbers to express decigrams, 
centigrams, or milligrams, in which case the designating denomina- 
tion should be written out in full. Fractions of these values should 
Ibe expressed in prescriptions in common fractions, and not in deci- 
mal fractions; thus: " i/ 2 milligram," and not " 0*5 milligram;" "i/ 4 
centigram," or " 2 1 /. 2 milligram," and not " 0-25 centigram." 

It is true that this use of the decimal point is not insisted upon by 
all writers on the metric system, but in the writer's opinion it should 
be so insisted upon in the interest of safety. 

The pharmacist will find little difficulty in using the metric system, 
if he will provide himself with a set of metric weights and measures, 
which can be obtained for a very few dollars. 

It is just as easy to place a gram-weight on one pan of a scale as it 
is to place a scruple-weight there, if you have it; or to fill a graduate 
to a line marked " 25 cubic centimeters," as to fill it to a line marked 
" 1 fluidounce." 

A pharmacist might as well try to substitute shots of various sizes 
for his grain weights, calculating from the number of grains in the 
prescription how many shots will be equivalent, as to calculate how 
many grains, drams, or ounces are equivalent to a certain prescribed 
metric quantity. Not only does the pharmacist who tries to save the 
trifling amount necessary to properly qualify him to dispense metric 
prescriptions take numerous chances of error, but he loses much val- 
uable time, and " time is money." Suppose that a pharmacist has 
only three metric prescriptions a week, and that each prescription 
averages four ingredients. He will have to calculate equivalents 624 
times a year, and at the rate of one minute only to calculate and verify, 
he spends a full working day each year in this unprofitable occupation, 
and incurs 624 chances of an error which may ruin his business, and 
all to save less than $5. If he has more prescriptions, say, two a day, 
he will devote full four days per year, and incur nearly 8,000 chances 
of error in the same time to save the same paltry sum. 

Every pharmacist should have the necessary metric weights and 



68 THE PRESCRIPTION. 

measures before he considers himself perfectly eauipped for his pro- 
fession. 

" Parts " in Formulas, 

" Parts " in the Pharmacopoeia means the proportion to be used of 
the different ingredients mentioned in the formula. When any one is 
accustomed to the use of parts he will find them much easier for calcu- 
lating the quantities required of each ingredient to make a certain 
total quantity of product. An example will make this clear: 

The formula for pulvis glycyrrhizce compositus is as follows: 

Take of 

Senna, No. 60 powder 18 parts. 

Glycyrrhiza, No. 60 powder 16 parts. 

Fennel, No. 60 powder 8 parts. 

Washed sulphur 8 parts. 

Sugar, fine powder 50 parts. 

To make ... 100 parts . 

Mix thoroughly. 

All " parts " are by weight, and we may assume each part to mean 
any definite quantity that we desire. If we assume each part to be 1 : 
dram, then we take of the different ingredients, 18, 16, 8, 8, and 50 
drams respectively; if we assume each part to be 1 grain, 1 ounce, or 
1 pound, we take 18, 16, 8, 8, and 50 grains, ounces, or pounds respect-; 
ively, as the case may be. Whatever weight we assume a part to be, 
we take 18, 16, 8, 8, and 50 times as much of each ingredient, according 
to its proportion, and the total will, of course, weigh just 100 times 
as much as the single part. 

If we want to make a definite quantity, say 1 pound, of the above 
preparation, we divide the total weight of 1 pound by 100 to ascertain 
the weight of 1 part. One pound is 7,000 grains, which, divided by 
100, will fix each part at 70 grains. Multiplying 70 grains by 18, 16, 
8, and 50 respectively, we have our formula as follows : 

Take of 

Senna, NTo. 60 powder l,260grs. 

Glycyrrhiza, No. 60 powder 1,120 grs. 

Fennel, No. 60 powder 560 grs. 

Washed sulphur 560 grs. 

Sugar, fine powder 3, 500 grs. 

Total 7,000 grs. 

We verify our calculation by adding, when we see that the total is 
7,000 grains, or 1 pound. 

Incidentally these formulas have the advantage of showing the per- 
centage of any ingredient at a glance, at least in those formulas in 
which the total product is either 100 or 1,000, and it is easily calcu- 
lated when it is 200, or any other number divisible by 100. In the 



WEIGHTS AND MEASURES. gQ 

preparation used as an example we have 18 per cent senna, 16 per cent 
glycyrrhiza, 8 per cent fennel, etc. 

It will be observed that it is much easier to use the formulae of the 
Pharmacopoeia with metric weights, and the metric system is, there- 
fore, rapidly coming into use. 

Or the pharmacist may obtain a set of Troemner's weights, ranging 
from 1,000 grains down— 1,000, 500, 200, 200, 100, 50, 20, 20, 10, 5, 2, 
2, 1, and fractions. By having in addition a lot of 1,000-grain weights, 
which each may cast for himself in solder metal, we can work much 
better and avoid the useless task of reducing the quantities in the 
above formula into pounds, ounces, drams, and grains, as we would 
have to do if we only had these weights. 

In using " parts," we must remember that they are always by 
weight, whether the material is solid or liquid, unless the contrary is 
especially mentioned. 

A formula may be written in " parts by measure," or " parts by vol- 
ume," when all ingredients are liquid. 

"Per Cent" Formulae. 

Quite frequently a pharmacist is called upon to dispense " per cent" 
solutions or preparations ; for instance, 4-per-cent solution of cocaine, 
2-per-cent solution of corrosive sublimate, etc. 

The term "per cent" or " per centum," means " per hundred," and 
a 2-per-cent solution is, therefore, a solution, 100 parts of which con- 
tains 2 parts of the proper ingredient. 

These formulae are compounded by weight. 

Suppose we have a call for 1 pint of 5-per-cent solution of carbolic 
acid in water. This is often written in the form of " proportions " in 
mathematics, thus : 

R— Solutionis acidi carbolici, 5:100, Oj. 
Signa: For external use. 

Or it may be written : 

R— Solutionis acidi carbolici, 5 per cent, Oj. 
Signa: For external use. 

When no solvent is mentioned, water is understood. 

To prepare this, we first find the value of 1 per cent of a pint. One 
pint of water, at ordinary temperatures, weighs, in round numbers, 
7,300 grains. The i/ioo part of 7,300 grains equals 73 grains, and 5 per 
cent is five times 73 grains, or 365 grains. Tare the bottle, and weigh 
into it 365 grains of carbolic acid, and then add enough water to make 
the total weight 7,300 grains. 

It is especially in calculating "percentage" preparations that we 
Will find the metric system exceedingly convenient. 



70 THE PRESCRIPTION. 

To compound, for example : 

R— Solutionis hydrargyri bichloridi, 2 $, 1 liter. 
M. S. : For external use. 

We figure thus: One liter equals 1,000 cubic centimeters, or weighs 
1,000 grams, of which 10 grams is 1 per cent and 2 per cent is, there- 
fore, 20 grams. We take, therefore, 20 grams of bichloride of mer- 
cury and the balance (980 grams) of water to make the total of 1,000 
grams of solution. It is true that this will not be accurately 1 liter, 
as we ignore the fact that 20 grams of the bichloride do not occupy 
the volume of 20 cubic centimeters when in solution, but it is accurate 
enough for practical purposes. 

It would be better to prescribe such solutions by weight rather 
than by measure. When all ingredients are liquids, they are some- 
times prescribed " by volume," but " by weight" is always understood 
when the contrary is not distinctly specified. When exact quantities 
by volume must be made, the pharmacist's knowledge of mathematics 
should enable him to make allowance for differences in specific gravi- 
ties, or he may make a little more of the solution than is prescribed, 
and then measure off the exact quantity. This is also necessary 
when large quantities of salts are prescribed in solution, as, for in- 
stance, 50-per-cent solutions of epsom salts, etc. 



Formulae by Proportions. 






Often these solutions, etc., are prescribed by proportion instead of 
by per cent, thus : 

Solutio potassii chloratis, 1:16. 

This means that Vi6 is to be chlorate of potassium and i 5 /i6 water. 
The methods of calculating are, of course, the same as in per cent 
preparations. 

Approximate Measures. 

It is customary to administer liquid medicines to the patient in cer- 
tain domestic measures, which, however, are not exact, but only ap- 
proximate equivalents of the liquid measures employed in compound- 
ing and dispensing. 

The following table includes the most useful of these approximate t 
measures. In the first column the domestic name of the measure is 
given ; in the second column, the equivalents in apothecaries' liquid 
measure; and in the third column, the equivalents in metric terms 

It will be noticed that the second and third columns do not always 
correspond, some of the metric terms being more than those of apoth- 
ecaries' liquid measure. This is owing to the fact that the teaspoon- 






WEIGHTS AXD MEASURES. 71 

ful is more nearly eighty minims than sixty minims, or one fluidram, 
and so with the other approximate measures. The metric equivalents 
are, therefore, more nearly correct than the others. 

Tabic of Approximate Measures. 

A teacupful = 1 fluidounces = 150 cubic centimeters. 

A wineglassf ul =2 fluidounces = CO cubic centimeters. 
A tablespoonful = 1/2 fluidounce = 20 cubic centimeters. 
A dessertspoonful = 2 fluidrams = 10 cubic centimeters. 
Ateaspoonful =1 fluidram = 5 cubic centimeters. 

On account of the inaccuracy of the spoons in general use, the ap- 
proximate measures should be discarded altogether, and accurate 
medicine glasses or graduated spoons be used instead. These medi- 
cine glasses may be had of various forms and definitely graduated so 
that the physician can have the medicine as accurately dosed out to 
the patient as it is measured off by the pharmacist when compounding, 
and the patient will, therefore, get exactly the dose which was intended 
for him. When a spoonful is ordered to be taken the patient seldom 
gets the full dose intended for him, because the attendant will not quite 
fill the spoon for fear of spilling the medicine over the bedclothes. 
This is especially the case when the patient is a child, because the 
latter will often struggle desperately to avoid taking the medicine. If 
no medicine glass is in the house, and the spoon must be used as a 
measure, the attendant should be instructed to hold the spoon over a 
wine-glass, fill it to the brim, and then pour the medicine into the 
wine-glass, from which it may be given to the patient without risk of 
spilling. 

The "drop" (gutta, ce, f.) is occasionally used as an approximate 
measure, but is so uncertain and variable in size that it should be dis- 
carded as much as possible. It may vary in size from 1/3 to 1 1/2 min - 
ims, depending on the viscidity, or fluidity, of the liquid and the shape 
of the lip from which it is dropped; so that not only drops of differ- 
ent liquids have different sizes, but also drops of the same liquid vary 
according to circumstances. 

The drop falling from the thin lip of some vial will be much smaller 
than the drop of the same liquid from the thick lips of a shelf -bottle. 

For instance : 

1 fluidram of alcohol = 118 — 143 drops. 

1 fluidram of water = 45—64 drops. 

1 fluidram of ether = 150— 200 drops. 

1 fluidram of creasote = 90 — 120 drops. 

1 fluidram of glycerin = 53 — 135 drops. 

1 fluidram of chloroform =180 — 276 drops. 

1 fluidram of tincture of chloride of iron = 106 — lol drops. 

1 fluidram of tincture of opium =106 — 147 drops. 

1 fluidram of croton oil = 70—92 drops. 

" Drop-machines' ' are made and sold, but they do not offer much 



72 THE PRESCRIPTION. 

advantage, except that of convenience, for the size of the drop varies 
much an hen dropped from these " machines" as when dropped 

from any other vessels. 

The viscidity of a liquid has, of course, a great influence on the size 
of the drop, and the viscid mucilage or oil will yield larger drops 
than thi hesive alcohol, chloroform, or ether. The above 

table Berrefl to show, however, to what extent drops of the same 
preparation may vary. The drop should, therefore, not be used in 

ription except when the quantity desired is so small or so vis- 
cid that it can not be measured in the minim measure; as, croton oil, 
creasote, or some of the volatile oils. 

The spoon (cochlear, aris, n., or cochleare, is, n., from cochlea, ce, f., 
a shell, a snail-shell) varies in size, and compound words are used 
in English to express the various sizes, while adjectives are used in ; 
Latin for the same purpose. 

The teaspoon (cochleare parvnm, small spoon) may be made of pew- 
ter, as used among the poor, when it often holds less than 60 minims. 
Silver and silver-plated teaspoons contain more nearly 80 minims. 
By careful pouring the teaspoon may be heaped full so as to contain 
more than 2 fluidrams. 

The dessertspoon (cochleare medium) is rarely employed, and by the 
poor is generally designated as a " child's spoon" (Kinder-Ice ffel, G.). 

The tablespoon (cochleare magnum, large spoon) also varies in size; 
with the material from which it is made. The pewter and Britanniai 
ware spoons are thick and hold less than the silver or plated spoons. 

If, therefore, spoons are to be used in administering the medicine 
the physician should ask to see the kind of spoons in the house, so 
that he may adjust his prescription accordingly. 

Solids are sometimes dispensed by approximate measure. "A hand- 
ful" (manipulus, i, m.) varies with the substance used, thus: 

A handful of barley seed = 80 grams. 

" flaxseed = 50 " I 

" flax meal =150 " 

The "pinch," or as much as can be held in a grasp of the thumb I 
and first two fingers, is also used. For example, a pinch of chamo-i 
mile equals 2 grams. 

Spoons are sometimes used to measure dry powders, and their val- j 
aea for this purpose we will state hereafter under the heading of J 
"Powders." 






PART III 



LANGUAGE. 

Advantage of Latin, Language. 

The Latin language is so generally employed all over the world for 
prescription writing, that it is very desirable that every pharmacist 
and physician should have at least an elementary knowledge of this 
language, and it is to be hoped that the time is not far in the future 
when such knowledge will be a fundamental requirement for admis- 
sion to apprenticeship in a drug store or a physician's office. 

The question, whether Latin should be used in prescriptions and in 
pharmacy, scarcely admits of debate, although some have argued that 
the vernacular languages would be preferable, because Latin is not 
generally understood. 

But there are various reasons why Latin is preferable. English or 
vernacular names vary in different parts of the same country; the 
same English names are applied to different drugs in the same neigh- 
borhoods; vernacular names are unintelligible to foreigners who have 

I settled among us; an English prescription written in one part of the 
country may be unintelligible in another part of the country, and is 
certain to be so in foreign countries; then, too, the patient can see 

\ and understand the English prescription, and it would arouse all his 

I ignorant prejudices, and the physician would be needlessly hampered 
in the treatment cf disease by the foolish notions of his patient. 

I Lastly, but not least, the public would soon know not only the nature 
of the ingredients of a prescription, but also their intrinsic values, and 
would, therefore, refuse to pay more than commercial profits for medi- 
cal treatment or medicines, and proper remuneration for professional 

► services and responsibilities would cease. 

There is still another reason to be urged against the abolition of the 

I Latin language as the language of medicine and pharmacy, and that is 

[that it would be lowering these sciences to the present unsatisfactory 
status of professional education and preliminary preparation, instead 
of elevating the professions to the higher level of education, as re- 
quired in European countries. The humiliating confession that but a 

\ small proportion of our physicians and pharmacists know anything 
about Latin, should urge us to use all our influence to better this state 
of affairs, rather than lead us to join the ranks of those who try to do 



74 THE PRESCRIPTION. 

without any scientific preliminary training. A universal language of 
science is a necessity, and, as Latin is a dead language, fixed in its 
rules, and not subjected to the changes necessarily incurred by liv- 
ing languages to accommodate themselves to new conditions of liv- 
ing, and especially as it is understood more or less perfectly by the 
educated in all countries, this is the best language for the nomen- 
clatures of the sciences and arts. Being the source from which so 
many of our English words were derived, it is also a very simple and 
easy language to learn, and, as was remarked before, every one who 
intends to study medicine or pharmacy should study Latin as an in- 
dispensable preliminary. The ignorance of Latin often shown in 
the prescriptions in some of the works of American writers on medi- 
cal subjects, renders American medical education a by-word among 
the nations, and makes each earnest friend of our country and our 
profession long for the day when the real worth of our physicians will 
no longer be hidden under the bushel measure of philological igno- 
rance. 

Familiarity with the nomenclature of our drugs and chemicals, and 
the construction of the names of galenical preparations in Latin, and 
a knowledge of at least the declensions, is necessary to be able prop- 
erly to read a prescription. It is true, a prescription may be written 
correctly by abbreviating the names of its ingredients according to 
certain simple rules not necessarily requiring a knowledge of Latin, 
but requiring a memorizing of the official names of drugs and prepara- 
tions. Or the physician may use these names in his prescriptions 
without modification on account of case, when his prescriptions will 
perhaps not be grammatically correct, but will certainly be intelligible 
anywhere. 

Grammatical Construction of Prescriptions. 

In these pages it will be impossible to give any extended instruc- 
tion in Latin, but some of the elementary rules regarding the gram- 
matical construction of the prescription may not be out of place. 

Let us consider the following: 

R— Magnesii sulphatis, %]. 
D. S.: Take at once. 

Or, literally translated into English: 

Take 
Of magnesia's sulphate, 1 ounce. 
Let it be given with the signature: Take at once. 
R (abbreviation for recipe) is the imperative mood of the active 
1 rrcipio, cepi, ceptum, 3, to take. It means " take," and its object 
I in the accusative case in Latin, which is similar to the object- 



LANGUAGE. 75 

ive case in English. " Take " what? " Take one ounce;" gj is a sign 
of quantity, and in writing can not "be altered according to case, but in 
reading is pronounced unciam uuam 9 or in the accusative following 
recipe. 

The quantities being generally written in signs, which are, of course, 
indeclinable, they offer little difficulty in writing, even if the writer is 
totally ignorant of Latin. 

" Take 1 ounce "—of what? of sulphate. This is written in Latin in 
the genitive case, which resembles the English possessive case. In 
Latin the construction would be " take the sulphate's 1 cunce." 

But there are many sulphates of various substances, and we must 
specify which of these sulphates we want. In the above prescription 
the sulphate of magnesia, or "magnesia's sulphate" is ordered. 
Magnesia, therefore, is also placed in the genitive (English, possessive) 
case. But this genitive was already necessary in the official name, 
and, therefore, the word magnesii of the official name requires no 
change by being used in a prescription . 

We see from the above that the prescription is the imperative 
"take," followed by the quantity, or object, in the accusative and 
the name of the drug in the genitive case. If the prescription contains 
two or more ingredients, the construction is, of course, the same for 
each. 

Then follow one or more imperatives or subjunctives, directing what 
shall be done with these ingredients; "in this case, "Detur (cum, un- 
derstood, or rather implied in the ablative) signatura" (let it be given, 
with the signature, or labeled), which instructs the pharmacist to place 
a label containing the words " take at once " on the package and then 
give it to the patient. 

When no quantity is mentioned in the prescription, the name of the 
ingredient or drug itself must be placed in the accusative case, as in 
the following prescription: 

R— Pilulas catharticas V. 

Or, in English : 

Take five cathartic pills. 

Here we have a numeral adjective, which, being written in character 
instead of in words, is, of course, really a sign, and is not altered ac- 
cording to case; and another adjective, "catharticas," which is declin- 
able and must be made to agree with its noun. 

Adjectives. 

In names with an adjective qualifying a noun the adjective is placed 
in the same gender, number, and case as the noun to which it belongs. 



7G THE PRESCRIPTION. 

In the above prescription both the noun pilulas (pills) and the adjec- 
tive catharticas (cathartic) are feminine gender, plural number, and 
accusative case. The numeral adjective quinque (five) is indeclin- 
able. 

In Pulvis ipecacuanha: composite s the adjective compositus (qualifying 
pulvis) must be declined in the same manner as pulvis, while ipecacu- 
anha- is a genitive, which remains as it is, no matter how the name of 
the preparation may be employed. 

In the name Oleum menthce piperita? the adjective does not modify 
the noun in the nominative, but the noun which is in the genitive case. 
It is" not a peppery oil of mint, but an oil of peppery mint (pepper- 
mint), and piperita*, therefore, is feminine, singular, genitive, agreeing 
with menthce. 

Prepositions, Adverbs, and Conjunctions. 

If any word follows a preposition, it must be placed in the case gov- 
erned by that preposition. Only three prepositions — ad, cum, and 
i n — are employed in prescriptions, and the cases governed by them 
are easily remembered. 

Ad (to) is followed by the accusative. Its use is explained further 
on. 

Cinn (with) governs, or is followed by, the ablative. The Latin ab- 
lative is the same as the English objective following with, from, by, 
or mi. The Latin word in the ablative includes the preposition, which 
is sometimes written, sometimes merely understood. Cum is occa- 
sionally used in names of preparations, as hydrargyrum cum creia. 
When such a name occurs in prescriptions, only the first word, the 
nominative, needs to be altered to the genitive, thus: g. — Hyclrar- 
gyri cum creta, gr. X. 

In (in or into) is followed by the accusative (equal to the object- 
ive case following a transitive verb or a preposition) when it implies 
a change from one form or condition into another, thus: Divide in 
pilulas XII (divide into 12 pills) ; but it is followed by the ablative 
when it implies a state of rest or position, as when we write: "Detur 
in vitro nigro " (let it be given in a black vial— literally, in a black 

Ana (avcx, of each) is an adverb used in prescriptions after the last 
of two or more successive ingredients of which equal quantities are 
ordered. It means " of each," or '" of each so much." It is usually 
written as a sign, aa, and is followed by the sign for the quantity. 

Et (and) is a conjunction. It is ofteu written, and is still more 
often to be understood when reading the prescription, as it is very 
frequently omitted in the subscriptions or directions to the drUg- 
g'St. 



language. 77 

Declensions. 

In Latin there are six cases— nominative, genitive, dative, accusa- 
tive, vocative, and ablative; of these the dative and vocative are not 
used in prescriptions. The nominative is practically the same in both 
languages; the genitive resembles the possessive case; the accusative 
is similar to the objective following a transitive verb; and the ablative 
is similar to the English objective following the prepositions with, 
from, in, or by. In Latin the case is indicated by a change in the ter- 
mination of the word — by " case endings;" for instance, we say rosa 
(nominative, the rose) and rosea (genitive, the rose's, or of the rose). 

As the great secret of elegant and correct prescription writing de- 
pends on a knowledge of the case endings of the words of the official 
and unofficial pharmaceutical names, the reader will no doubt find it 
of interest to have his memory refreshed if he has already studied 
Latin, or to learn the declensions now if he has never done so before. 

A noun is often modified in form by the case in which it must be 
placed, and it is, therefore, of importance to understand what is meant 
by " case." It has been stated by writers on this subject that case is a 
word which signifies condition or relation. The relation which a noun 
bears to the other words of a sentence determines its case, and, as 
the case is expressed by the form of the word, this relation determines 
the peculiar modification, if any, that is necessary to show the case. 

When a noun or pronoun is simply named, or is named as doing 
something — that is, as the subject of a verb — it is said to be in the 
nominative case (from the Latin adjective, nominativus, a, urn, apper- 
taining to naming; in turn, from nomen, inis, n., name). Thus, when 
we say "John," John is in the nominative case, because merely 
named; or, if we say, "John studies," John is also in the nomina- 
tive case, because John is named as the subject of a verb. 

Whenever a noun or pronoun is named as the possessor of some- 
thing, it is placed in the possessive case (from possessus, us, m., or 
possessio, onis, f ., possession) . When we say "John 's hat," the name 
of John is modified by the addition of an apostrophe and an " s" to im- 
ply possession on the part of John. In English, possession is often 
expressed by the name of a noun in the objective case following the 
preposition of, thus: The hat of John means the same as John's hat. 
And this method of expression is most commonly employed in trans- 
lating from the Latin genitive case (equivalent to the English posses- 
sive;, and /em citras is, therefore, translated to citrate of iron rather 
than to iron's citrate, which latter would be the literal translation. 

When a noun or pronoun is mentioned as affected by the action of 
some one or something else, either directly or indirectly— or, in other 
words, when it is the object of an action— it is said to be in the 
objective case (from objectum, the supine of objicio, jeci, jectum, 3, to lay 



78 THE PRESCRIPTION. 

before, to expose to). A noun or pronoun following a transitive 
verb is in the objective case, as when we say, " the patient swallows 
pills, " or when we say in the prescription, "take 1 ounce, " etc. In 
the first example the word " pills" is in the objective case; in the 
second, the word " ounce." 

Or, a noun may be in the objective case when it follows a preposi- 
tion— of, with, in, by, etc. In the sentence, "the medicine is in the 
bottle," the word bottle is in the objective case, following " in." 

The relation of the words to each other and to the verbs of the sen- 
tences determines the cases, and, as these circumstances vary, the 
cases are altered. "Circumstances alter cases" was not originally 
intended to be used in this connection, but it applies quite forcibly 
nevertheless. The whole subject of cases is made very plain in 
French's "A Word to the Wise," from which the following is an ex- 
tract: " I will now tell you how you may always distinguish the three 
cases. Read the sentence attentively, and understand accurately what 
the nouns are represented as doing. If any person or thing be repre- 
sented as performing an action, that person or thing is a noun in the 
nominative case. If any person or thing be represented as possessing 
something, that person or thing is a noun in the possessive case. And 
if any person or thing be represented as neither performing nor pos- 
sessing, it is a noun in the objective, whether directly or indirectly 
affected by the action of the nominative ; because, as we have in 
English but three cases which contain the substance of the six Latin 
cases, whatever is neither nominative nor possessive must be object- 
ive" 

In Latin there are six cases : The nominative (equivalent to the Eng- 
lish case of the same name) ; the genitive (equivalent to the English 
possessive case) ; the dative (equivalent to the English abjective fol- 
lowing the preposition "to," as in the sentence, "it is given to 
John "), which is rarely or never used in prescriptions; the accusative 
(equivalent to the English objective after a transitive verb, or such 
prepositions as "to" or " into," etc.) ; the vocative (used in appella- 
tion, as when we say, "Hello, John"); and the ablative (equivalent 
to the English objective following such prepositions as "from," 
"with," "in," or "by"). 

Of these six cases the dative and vocative may be ignored for our 
purposes because they are not used in prescription writing. 

As pronouns are not used in prescriptions except as " understood " 
in the imperatives recipe (take, or take thou), misce (mix, or mix thou), 
etc., we need not speak about them, and can restrict our remarks for 
the present to nouns. With very few exceptions Latin nouns alter 
their forms according to the case in which they stand, and this altera- 
tion consists in a change of the last syllable or termination. Nouns 
wnich do not undergo such changes are said to be indeclinable, which 






LANGUAGE. 79 



is generally expressed in dictionaries by the abbreviation "indecl." 
after the word, thus : "catechu, indecl." 

There are five declensions in Latin, depending on the change of the 
i nominative to the genitive— that is, therefore, according to the forma- 
tion of the genitive. 

The genitive endings of the different declensions are as follows: 

First declension ae (often printed se) # 

Second declension i. 

Third declension is. 

Fourth declension us. 

Fifth declension ei. 

By dropping the ending from the genitive singular the stem of the 
word is found, and the other cases are then obtained by adding the 
respective case endings. 

First Declension. 

This declension comprises all pharrnacopoeial names or nouns end- 
ing in a, except phy so stigma and coca. They are feminine gender, and 
the cases are formed in the singular by changing the final a to ce in 
the genitive, am in the accusative, while the ablative is like the nomi- 
native, ending in a. In the plural the nominative is ae; the genitive, 
arum; the accusative, as; and the ablative, is. 

Or, placing this in tabular form, the endings of the first declension 
are thus : 

Singular. Plural. 

Nominative a. ae. 

Genitive ae. arum. 

Accusative am. as. 

Ablative a. is. 

The plural is rarely employed in prescriptions, our Pharmacopoeia 
using the singular in the nomenclature of drugs and preparations. 
European works, however, frequently use the plural, and it is, there- 
fore, thought advantageous to give the endings for the plural also. 

Declining the word gutta, we have the following forms : 

Singular. 

Nominative gutta, a drop. 

Genitive guttce, of a drop. 

Accusative guttam, a drop. 

Ablative gutta, with, from, or by a drop. 

Plural. 

Nominative guttce, drops. 

Genitive guttanm, of drops. 

Accusative guttas, drops. 

Ablative guttfc, with, from, or by drops. 



80 THE PRESCRIPTION. 

Some words, as used in pharmacy, have no plural, as, for instance, 
acacia, which is only used in the singular number. It is true, how- 
ever, that this same word, when applied to the acacias or the trees 
from which the drug is derived is used in the plural form. 

The student who has never studied Latin, but who wishes to get a 
rudimentary knowledge of the subject of Latin case modifications, 
will find it profitable to decline a few nouns in the above manner, 
ignoring the plural, if he prefers, as he will make little use of it in 
prescription writing. Let him take for this purpose a few such words 
as achillea, althcea, ammonia, amygdala, aqua, bacca, brayera, ergota, 
cinchona, fluidrachma, fluiduncia, etc., not forgetting that coca and 
physostigma are exceptional words which are not declined according 
to the first declension. 

There are some Latin words which are declined according to the 
first declension, which are from Greek nouns, and which end in e, 
and of which the case endings are irregular. They are declined : 

Singular. 

Nominative e. 

Genitive es. 

Accusative en. 

Ablative e. 

The only words used in prescriptions which have this form are aloe, 
mastiche, and statice, none of which are used in the plural, for which 
reason we omit the latter; besides the plural is regular, and, there- 
fore, needs not to be repeated. 

As already stated, adjectives must agree with their nouns in num- 
ber, gender, and person. All nouns of the first declension which are 
used in prescriptions, end in a or e, and are feminine. The feminine 
form of adjectives of the first and second declensions end in a, and 
such adjectives are declined like gutta, above. The masculine and 
neuter forms are declined according to the second declension. The 
three forms of these adjectives are printed in dictionaries according 
to this manner: Aromaticus, a, urn, adj., aromatic— of which the first is 
always masculine, the second feminine, and the last the neuter form. 

Second Declension. 

Pharmaceutical nouns ending in us are declined according to the 
second declension, and are of masculine gender. A few words, how- 
ever, ending in us are exceptions to this rule and are declined accord- 
ing to the third or fourth declensions. Nouns ending in os are also 
declined according to this declension, and may be masculine or fem- 
inine. Nouns ending in urn or on (not increasing in the genitive) are 



; 



LANGUAGE. 



81 



also declined according to this declension and are of neuter gender. 
All of them form the genitive by changing the nominative ending to i. 
The case endings of the above forms of words of the second declen- 
sion are as follows : 

Singular. 

Nominative us. os. urn. on. 

Genitive i. i. i. i. 

Accusative um. on. um. on. 

Ablative o. o. o. o. 

Plural. 

Nominative i. i. a. a. 

Genitive oruni. orum. ornni. orum. 

Accusative .os. os. a. a. 

Ablative is. is. is. is. 

Words ending in us or um are the common pure Latin masculine 
and neuter forms of the nouns of the second declension. The nouns 
ending in os or on are of Greek origin. 

Nouns ending in the common form of us are declined as follows : 

Singular. 

Nominative syrupz^s, syrup. 

Genitive syrup*, of syrup. 

Accusative syrupum, syrup. 

Ablative syrupo, with, from, or by syrup. 

Plural. 

Nominative syrup*", syrups. 

Genitive syruporum, of syrups. 

Accusative syrupos, syrups. 

Ablative syrnpis, with, from, or by syrups. 

The student may practice by declining in the same manner such 
words as calamus, coccus, crocus, eucalyptus, ficus, humulus, moschus, 
ricinus, succus, vitellus, etc. 

All pharmaceutical nouns and adjectives ending in us are declined 
as above except rhus, n., and fortius, adj., which are of the third 
declension; comus, haustus, potus, fructus, quercus, and spmtus, 
which are of the fourth declension (which see), and unus, adj., the 
genitive of which ends in ius. 

It must be remembered also that the words alnus, juniperus, 
prunus, rhamnus, sambucus and ulmus, although ending in us and de- 
clined like the common masculine nouns of the second declension, are 
of the feminine gender and the adjectives must, therefore, have the 
feminine form in order to agree with their nouns, thus: Prunus vir- 
giniana, ulmus fulva, etc. 



g2 THE PRESCRIPTION. 

Nouns of Greek origin ending in os are generally masculine, and the 
cases are formed like those of nouns ending in us, except that the ac- 
cusative singular ends in on. Cissampelos, f., diospyros, f., snulprinos, 
m., are nouns declined thus: 

Singular. Plural. 

Nominative diospyros. diospyn. 

Genitive diospyri. cliospyronem. 

Accusative diospyrow. diospyros. 

Ablative diospyro. diospyris. 

Regular Latin neuter nouns of the second declension end in um, and 
are declined as follows : 

Singular. Plural. 

Nominative acidwwi. acida. 

Genitive acidi. acidorwwi. 

Accusative aciclwm. acida. 

Ablative acido. acidis. 

The student will do well to decline absinthium, aconitum, amylum, 
argentum, balsamum, calcium, capsicum, chloroformum, collodium, de- 
coctum, emplastrum, extraction, infusion, linum, oleum, rheum, sodium, 
vinum, zincum, and other nouns ending in urn, in the same manner as 
acidum. 

The only exception to the rule that nouns or adjectives ending in 
um, which are used in prescriptions, are declined as above, is the 
neuter form of the adjective unus, a, um, which has the ending ius in 
the genitive. 

Nouns of Greek origin ending in on are neuter, and are declined in 
the same manner, except that the nominative and accusative singular 
end in on, instead of um. 

Singular. Plural. 

Nominative erythroxylora. erythroxyla. 

Genitive . erythroxyK. erythroxyloriwi. 

Accusative erythroxylow. erythroxyla. 

Ablative erythroxylo. erythroxylis. 

Hamatoxylon, liriodendron, pyroxylon, and toxicodendron are de- 
clined in the same way. 

Erigeron, however, is an exception, being declined according to the 
third declension, and forming its genitive thus: Engerontis. 

Third Declension. 

The third declension is somewhat peculiar in construction, and 

many words with very unlike endings are declined according to it. 

With very few exceptions, already mentioned or yet to be mentioned, 



LANGUAGE. 

all nouns not ending in a, us, or urn are of the third declension. N 

in this declension may end in a, e, i, o, y, c, 1, n, r, s, t, or x, and 

may be masculine, feminine, or neuter. 

On account of the variety and irregularity of its case endings this 
declension is the most difficult to learn, but it may be remembered 
that a large number of nouus of this declension end in as, which is 
changed to atis in the genitive, thus: acetas, genitive ace tat is; the 
exceptions being asclepias, genitive asclepiadis, and mas, genitive maris. 

Nouns ending in go are feminine, and the genitive ends in ginis. 
Nouns ending in io, formed from a verb, are feminine, and the geni- 
tive changes the o to onis. Nouns ending in ma are neuter, and have 
a changed to atis in the genitive. 

The nouns of this declension may be divided into two classes : those 
having a case ending in the nominative and those having none. In 
the first class the stem of the word is contained in the nominative, 
together with the ending which ends in e, s, or x; in the second class 
the nominative singular is either the same as the stem, as in chloral, 
genitive chloralis, or it is formed by dropping or changing one or more 
letters of the stem. 

It will be remembered that the stem of a declinable word is ascer- 
tained by dropping its genitive ending. (See page 79.) In the word 
lotto, genitive lotionis, the stem of the word is lotion, and the nomi- 
native is formed by dropping the final n of the stem. In the word 
| radix, genitive radicis, the stem of the word is radic, and the nomi- 
native is formed by changing c to x. In the word cortex, genitive 
corticis, the stem is cortic, and the nominative is formed by changing 
the c to x, and the vowel i to e. 

The other cases are formed by dropping the is of the genitive and 
placing the proper endings instead. 

The case endings of the third declension are as follows : 

Singular. 
Male and Female . Neuter . 

Nominative s (es, is) , . e, . 

Genitive is. is. 

Accusative cm (im). like nominative. 

Ablative e (i) . C (-)■ 

Plural. 

Nominative es. a (ia). 

Genitive um (mm) . urn (mm) . 

Accusative es. a C ia ) • 

Ablative ibus. ibus. 

The dash in the nominative singular means that the case ending is 
wanting. 



gj THE PRESCRIPTION. 

In order to decline words of the third declension properly we must g 
know the nominative and genitive singular and the gender in order to I 
choose the proper set of case endings. In dictionaries these words i 
arc, therefore, in the following form: Mucilago, inis, f., mucilage. 

It would lead us altogether too far to explain when the endings um 
or ium should be used in the genitive plural, or when a or ia are proper 
in the nominative or accusative, plural, neuter; nor is it necessary, as 
it is not customary in this country to use the plural in prescriptions, 
and the above table of the case endings will enable the student to 
recognize the cases if he should come across them in his reading. 

The ablative singular also is very rarely used in prescriptions, but 
it may be remembered that the ending e is used in most nouns; i is 
used in neuters ending in e, al, and ar; in adjectives in er or is when 
used as nouns; in nouns with im in the accusative, etc. This can not 
be fully explained except by a thorough consideration of the rules of 
the Latin language, which is beyond the scope of our present writing. 

No one characteristic example of this declension can be given, as it 
is too irregular. 

Fourth Declension. 

A few Latin words used in prescriptions are declined according to 
the fourth declension. They end in us, m., and u, n., and have us as 
the case ending of the genitive singular. 

The following are the case endings of this declension. 

Singular. 

Nominative ,. us. u. 

Genitive us# us# 

Accusative um. u. 

Ablative ll# u# 

Plural. 
Nominative us . ua . 

Genitive uum. uum. 

Accusative us . ua# 

Ablative ibus- ibus# 

Nouns of this declension ending in us are generally masculine; 
those ending in u are neuter. The word fructus, m., is thus declined: 

Singular. Plural. 

Nominative fructws. fructus. 

Genitive fructws. iructuum. 

Accusative , . . . . fructwwi. fructws. 

Ablative fructw. ivuetibus. 

In the same manner the following may be declined: Haustus, us, m., 
pottts, us, ra., spiritus, us, m., quercus, us, i. } and cornus, us, f . The 



LANGUAGE. 85 

last word must not be confounded, however, with cornu, ws,horn, used 
as the name of an almost obsolete drug: cornu cervi, or hart's horn. 

Fifth Declension. 

Only two words of this declension are used in prescriptions, namely, 
dies, ei, m., or f., day, which is sometimes used in signatures, thus: 
" ter in die," and species, ei, f ., a mixture of herbs for teas. 

Singular. Plural. 
Nominative es# es> 

Genitive ei. erum. 

Accusative ein# es# 

Ablative e. ebus. 

Dies is declined thus, but species, according to some authors, has no 
genitive, dative, nor ablative plural. 

Indeclinable Nouns. 

Several nouns used in pharmacy and prescriptions are indeclinable. 
That is, the case endings for all cases are alike, and these words, there- 
fore, remain unchanged, no matter what may be the case. 
The following is a partial list of these words : 

Alcohol, Coca, Kousso, 

Amyl, Curare, Mais, 

Azedarach, Elemi, Matico, 

Buchu, Jaborandi, Sago, 

Catechu. Kino, Sassafras. 

Others are included in the list of words further on. 
Indeclinable nouns are neuter, and the adjectives must agree by also 
being used in the neuter form. 

Two of the above words are somewhat peculiar, however. Alcohol, 
n., indecl., is neuter, and is so used in the Pharmacopoeia, for 
instance, in the title alcohol dilution. But according to many good 
authorities, to the acceptance of whose views the writer confesses 
preference, alcohol is not indeclinable, but is alcohol, olis, m., and 
the pharmacopceial title should, therefore, be alcohol dilutus . 

When the Latin w r ord for Indian corn or maize is spelled mais it is 
indeclinable and neuter, but when spelled mays, it is mays, dis, f . ; that 
is, it is declinable according to the third declension, and is feminine. 
We may, therefore, say either ustilago mais, or ustilago maydis. 

Adjectives. 

Adjectives are parts of speech used to qualify nouns, as, the good 
man, the beautiful woman. In English the adjective has one form only 



86 THE PRESCRIPTION. 

no matter whether it applies to a masculine, feminine, or neuter noun, 
or in what case such noun may be ; in other words, adjectives are inde- 
clinable in English. In Latin, however, adjectives have different gen- 
der endings as well as different case endings, and mast, therefore, be 
declined to agree with their nouns, as, for example, if we consider alco- 
hol indeclinable and neuter, then the Latin title for diluted alcohol is 
alcohol dilutum, while if we consider it declinable it is masculine, and 
the adjective must have the masculine ending us, thus : alcohol dilutus. 

Some adjectives have three forms, masculine, feminine, and neuter; 
of which the feminine form is declined according to the first, and the 
masculine and neuter according to the second declension. 

All other adjectives are of the third declension. 

Adjectives of First and Second Declensions. 

All adjectives used in prescriptions which are declinable according 
to the first and second declensions, have the following endings in the 
nominative singular: 

Masculine. Feminine. Neuter. 

us. a. um. 

In dictionaries it is customary to give the masculine form, followed 
by the feminine and neuter endings and the letters " adj.," thus: Am- 
arus, a, um, adj., bitter. These adjectives are declined regularly, like 
nouns of the corresponding declensions. Some irregular forms of 
adjectives of the second declension occur also, as, for example, those 
ending in er, etc., but as the writer can not remember any of these 
that are likely to occur in a prescription, it does not seem necessary to 
dwell on the method of declining them. 

The only irregular adjective of the first and second declensions 
used in prescriptions, is unus, a, um, of which the genitive in all three 
genders is unius. 

Adjectives of the Third Declension. 

These are divided into three classes, according to the peculiarities 
of their endings in the nominative singular : 

1. Those that have a different ending for each gender: 

Masculine. Ferainine. Neuter. 
Nominative er. is. e. 

As in acer, acris, acre, sharp. 

2. Those having the same ending for masculine and feminine, and 

another for neuter: 

Masculine. Feminine. Neuter. 
Nominative is. is. e. 

As in dulcis, dulce, sweet. 



LANGUAGE. gy 

3. Adjectives with only one ending for all three genders. These 
endings generally have as a final letter s or x, as infelix, ids, happy; 
fragrans, antis, fragrant; princeps, ipis, first, most important, etc.'; 
more rarely they end in I or r. 

All adjectives of this declension are declined like nouns of the same 
declensions and of corresponding endings, with certain exceptions, 
prominent among which is that the ablative generally ends in i, in- 
stead of in e as is the rule with nouns. 

Comparison of Adjectives. 

In Latin as in English we may compare adjectives in three ways: 
first, by changing the endings; second, by joining with an adverb; 
and third, irregularly, by the use of different words. 

In both languages, also, we have the three degrees, the positive, 
comparative, and superlative. Examples: 

1. Plain, plainer, plainest. 

2. Beautiful, more beautiful, most beautiful. 

3. Good, better, best. 

In Latin, adjectives are compared regularly by adding to the stem of 
the ordinary or positive form, which, as will be remembered, is ob- 
tained by dropping the genitive endings, the following endings: 

Masculine. Feminine. Neuter. 

Comparative ior. ior. ius. 

Superlative issimus. issima. issimum. 

Thus: Altus, a, um, high; altior, ius, higher; altissimus, a, um, high- 
est. 

The following irregularities may be noted : 

Adjectives ending in er add rimus in the superlative, as acer, sharp; 
acerrimus, sharpest. Also, 

Positive. Comparative. Superlative. 

Good bonus. melior. optimus. 

Bad malus. pejor. pessimus. 

Large magnus. major. maximus. 

Much multus. plus. plurimus. 

Small parvus. minor. minimus. 

The formation of a comparative or superlative by aid of an adverb 
is not apt to occur in prescription writing. 

Numeral Adjectives. 

The writing of numbers in prescriptions offers no difficulty to any 
one not a Latin scholar, as the ordinary Eoman notation is used. All 



88 



THE PRESCRIPTION. 



numbers are expressed by one or a combination of two or more of the 
following letters: I, V, X, L, C, D, M. I means 1; V, 5; X, 10; 
L, 50; C, 100; D, 500; and M, 1,000. These should be written alto- 
gether as capital letters, but in prescriptions we And them much more 
frequently written as small letters, or, in print, as lower-case letters, 
and it is also customary to write the last I, when several are placed 
together, like a printed lower-case "j." The letters are combined 
thus: 

1 1 VIII 8 LX 60 

II 2 IX 9 XC 90 

III 3 X 10 C 100 

IV 4 XI '... 11 CC 200 

V 5 XX 20 DC 600 

VI 6 XL 40 M 1,000 

VII 7 L 50 MDCCCLXXXVI 1886 

It will be noticed that four is written IV, the letter I (1) prefixed to 
V (5), meaning " one less than five." In the same manner nine is 
written IX, or " one less than ten;" forty, XL, or " ten less than 
fifty;" and ninety, XC, or " ten less than one hundred." Numbers are 
written by merely commencing with the largest at the left, then the 
next largest, and so on, according to value of the single letters, until 
the total is the number which we wish to express. In the example of 
the number of the year, above, this may be seen. 

In reading prescriptions it is necessary to know the names of car- 
dinal as well as ordinal numerals, which are found in the following 
columns : 

The cardinal numbers are read one, two, three, etc. ; the ordinals, 
first, second, third, etc. 

Cardinals . 

1 I. unus, a, um. 

8-... II. duo,duse, duo. 

3 III. tres, tria. 

4 IV. quatuor. 

5 V. quinque. 

6 VI. sex. 

7 VII. septem. 

8 VIII. octo. 

9 IX. novem. 

10 X. decern. 

11 • XI. unclecim. 

1 - XII. duodecim. 

13 XIII. tredecim. 

1** XIV. quatuordecim. 

15 XV. quindecim. 



Ordinals, 
primus, 
secundus. 
tertius. 
quartus. 
quintus. 
sextus. 
septimus. 
octavus. 
nouus. 
decimus. 
undecimus. 
duodecimus. 
tertius decimus. 
quartus decimus. 
quintus decimus. 



LANGUAGE. M . 

017 

Cardinals. Ordinals. 

16 XVI - sexdecim, sextus decimus. 

17 XVII. septendeeim. Septimus decimus. 

18 XVIII. duodeviginti. duodevicesimus. 

19 XIX. undeviginti. undevicesimus. 

20 XX. viginti. vicesimus. 

21 3tf I. viginti trims* vicesimus primus. 

22 XXII. vigiuti duo. vicesimus secundus. 

30 : XXX. triginta. tricesimus. 

40 XL. quaclrigirita. quaclragesimus. 

50 L- quinquagiuta. quinquagesimus. 

60 LX. sexaginta. sexagesimus. 

70 LXX. septuaginta. septuagesimus. 

80 ... . LXXX . octoginta. octogesimus. 

yO XC. nouaginta. nonagesimus. 

100 C. centum. centesimus. 

101 CI. centum unus. centesimus primus . 

200 CC. ducenti, as, a. ducentesimus 

300 CCC. trecenti. trecentesimus. 

400 CCCC. quadrigenti. quadriugentesimus. 

500 D. quingenti. quingentesimus. 

600 DC. sexcenti. sexcentesimus. 

700 DCC. septingenti. septiugentesimus. 

800 DCCC. octingenti. octingentesimus. 

900 DCCCC. nongenti nongentesimus. 

1,000 M. mille. millesimus. 

All of the ordinals have all three gender endings — us, a, um — and are 
declined like all other adjectives of the first and second declensions. 
Of the cardinal units, only unus, duo, and tres are declined. All 
tens and centum are indeclinable. The hundreds are declined as plu- 
rals of the first and second declensions, thus: ducenti, ce, a. Mille is 
also sometimes declined as a neuter of the third declension. 
Unus, a, um; duo, cv, o ; and tres, tria are declined as follows: 

Masculine. Feminine. Neuter. 

Nominative unus. una. unum. 

Genitive uuius. unius. unius. 

Accusative unum. unam. unum. 

Ablative uno. una. uno. 

Nominative duo. duae duo 

Genitive duorum. duarurn. duorum. 

Accusative duos or duo. duas. duo. 

Ablative duobus. cluabus. duobns. 

*Or, unus et viginti, etc. 



90 THE PRESCRIPTION. 

Masculine. Feminine. Neuter. 

Nominative tres. tres. tria. 

Genitive trium. trium. trium. 

Accusative tres. tres. tria. 

Ablative tribus. tribus. tribus. 

Fractions can only be expressed in words, with the exception of 
"half," which is abbreviated to " ss " or "ft." The first of these signs 
is an English double "s," the second a German double "s;" both 
from the Latin adjective semissis, e, half. Other fractions are written 
by adding to the word pars, tis, f. (part), the ordinal numeral which 
expresses the fraction, as, pars decima, the tenth part; pars vicesima 
quarta, the twenty-fourth part. The word pars may either be ex- 
pressed or understood. 

In prescriptions it is customary to depart from the Latin and use 
Arabic numerals for all fractions less than one-half; "one-fifth of a 
grain'' would, therefore, be written "gr. Vfi»" aud not "grant pars 
quintal 

Participles. 

Participles are declined like adjectives. They give the meaning of 
a verb in the form of an adjective, thus: Aqua balUens, boiling water; 
bulliens being a participial adjective from the active present participle 
of the verb bullio, ivi, iturn, 4, to boil. These active present par- 
ticiples form adjectives of the third class of the third declension. 

The active future and the passive perfect and future participles are 
also used as adjectives, and as they end in us, a, um, they are declined 
like adjectives of the first and second declensions. Of these forms the 
passive future participle is sometimes used in the subscription of a 
prescription, as when we say, "fiat massa dividenda in piluJas XXIV;" 
let a mass, to be divided into 24 pills, be made. 

List of Nouns and Adjectives. 

For convenience of reference we append an alphabetical list, of 
nouns and adjectives likely to occur in prescriptions. The list is nee- - 
essarily incomplete, because there are many obsolete or obsolescent 
words, as well as some new ones not yet in general use, which may 
occasionally find their way into a prescription, that are not here enu- 
merated. The following abbreviations following the words are used: 
The numbers refer to the declensions; "m." means masculine; "/.," 
feminine; and "».," neuter; "adj." is adjective or participial adjec- 



LANGUAGE, 9^ 

tive; "indecl." designates indeclinable words. All words are nouns 
unless otherwise marked. 

Words are regularly declined when they are designated only by a 
number following, and unless marked otherwise all followed by "1" 
are understood to be of the first declension, feminine; if marked " 2," 
means of second declension, and masculine if ending in us or os, or 
neuter if ending in um or on, exceptions being marked by the letter 
indicating the gender. After adjectives ending in us, a, um, no num- 
ber is given, as it is understood that these are declinable according to 
the first and second declensions. The English meaning is not given, 
as this list is not intended for dictionary purposes, but to ascertain 
the method of declining. 

As the genitive singular is used so much more frequently than any 
other case, it may prove of use to call attention to the following reca- 
pitulations : 

1. All words of this list ending in a and marked " 1," form the geni- 
tive by changing the a to " . 

2. All words of this list ending in us, os, um, or on and marked 
" 2," change the above endings to i in the genitive. 

3. Adjectives and participial adjectives ending in us, a } or um form 
their genitives in a corresponding manner. 

4. All other words of this list have the genitives stated, but it maybe 
convenient to remember that usually words of the third declension 
ending in as change this to atis in the genitive; ending in ma, change 
a to atis; ending in go, change o to into; and ending in io, change o to 
onis. The genitive singular of the third declension ends in s or is, and 
the nominative ending is, quite frequently, although by no means 
always, changes to idis in the genitive. 

Some of the words in this list have the genitive formed in different 
ways, and in such cases, if both are more or less in use, both are given ; 
the first one being, in the judgment of the writer, more commonly 
used. See, as examples: Alcohol, antlwnis, decoctum, elixir, etc. 

In some cases where a word has two forms, one of which is common 
while the other is quite uncommon, the latter is omitted, as in hydras- 
tis, the genitive of which is generally Hydrastis, although some au- 
thorities give it as hydrastidis. So also some words may be marked 
with one gender while some authorities occasionally give another gen- 
der, but it is believed that the list gives the best usage in these re- 
gards. 

Reference List. 

Abrus, 2. Acacia, 1. 

Absinthium, 2. Acer, acris, acre, 3; adj. 

Abstractum, 2. Acetas, atis, 3, m. 






THE PRESCRIPTION. 



Acetatus, a, um; adj. 
Aceticus, a, um; adj. 
Acetum, 2. 
Achillea, 1. 
Acidum, 2. 
Aconitina, 1. 
Aconitum, 2. 
Aetata, 1. 
Adeps, ipis, 3, m. 
Adlnusivus, a, um; adj. 
Adiantum, 2. 
JEqualis, e, 3; adj. 
JErugo, inis, 3. 
.Ether, is, 3, m. 
iEthereus, a, um; adj. 
Agaricus, 2. 
Ailautus, 2,/. 
Albumen, inis, 3, n. 
Albus, a, um; adj. 
Alcohol, indecl. y n.; or 

Alcohol, olis, 3, m. 
Alcoholicus, a, um; adj. 
Aletris, idis, 3, /. 
Allium, 2. 
Alnus, 2,/. 
Aloe, es, 1,/. 
Aloinum, 2. 
Alstonia, 1. 
Althaea, 1. 
Alumen, iuis, 3, n. 
Aluminium, 2. 
Amarus, a, um; adj. 
Americanus, a, um; adj. 
Ammonia, 1. 
Ammoniacum, 2. 
Ammoniatus, a, um; adj. 
Ammonium, 2. 
Ampelopsis, is, 3, /. 
Amygdala, 1. 
Amyl, indecl.; n. 
Amylicus, a, um; adj. 
Amylum, 2. 
Angelica, 1. 
Angustura, 1. 



Auimalis, e, 3; adj. 
Anisatus, a, um; adj. 
Anisum, 2. 

Anthemis, is, 3, /.; or 
Anthemis, idis, 3,/. 
Antidotum, 2. 
Antimonium, 2. 
Aperiens, ntis, 3; adj. 
Apiolum, 2. 
Apocynum, 2. 
Apomorphina, 1. 
Aqua, 1. 
Aralia, 1. 
Areca, 1. 
Argentum, 2. 
Arnica, 1. 

Aromaticus, a, um; adj, 
Arsenias, atis, 3, mi. 
Arsenis, itis, 3, m. 
Arsenicum, 2. 
Arseniosus, a, um; adj. 
Arsenium, 2. 
Arum, 2. 
Asafoetida, 1. 
Asarum, 2. 
Asclepias, adis, 3, /. 
Asellus, 2. 
Aspidium, 2. 
Aspidosperma, atis, 3, n. 
Atrophia, 1. 
Aurantium, 2. 
Au rum, 2. 
Ava kava, indecl. 
Arena, 1. 
Axungia, 1. 
Azederach, indecl. 
Bacca, 1. 
Balsam um, 2. 
Baptisia, 1. 

Barbadensis, e, 3; adj. 
Barium, 2. 
Beberina, 1. 
Belladonna, 1. 
Benzoas, atis, 3, m. 



LANGUAGE. 






Benzoe, oes, 1,/. 
Benzoicus, a, um; adj. 
Benzoinatus, a, um; adj. 
Benzoinum, 2. 
Berberina, 1. 
Berberis, iclis, 3 , /. 
Bergamum, 2. 
Biboras, atis, 3, m. 
Bicarbonas, atis, 3, m. 
Bichloridus, a, um; adj. 
Bichromas, atis, 3, m. 
Bismuthum, 2. 
Bisulphas, atis, 3, m. 
Bitartras, atis, 3, m. 
Blatta, 1. 
Bolclus, 2. 
Bolus, 2. 
Boras, atis, 6, in. 
Borax, acis, 3, m. 
Boricus, a, um; adj. 
Brayera, 1. 
Bromidum, 2. 
Bryonia, 1. 
Buchu, indecl. 
Bullieus, entis; adj. 
Bunrundicus, a, um; adj. 
Bursa, 1. 
Butyrum, 2. 
Cacao, indecl. 
Cactus, 2. 
Cadmium, 2. 
Caffea, 1. 
Caffeina, 1. 
Cajaputi, indecl.; or 

Cajaputum, 2. 
Calamus, 2. 
Calcium, 2. 
Calendula, 1. 
Calisaya, 1. 
Calomel, (tided. 
Calumba, 1. 
Calx, cis, 3,/. 
Camellia, 1. 
Camphora, 1. 



Camphoratus, a, um; adj. 

Canadensis, e, 3; adj. 

Canella, 1. 

Canna, 1. 

Cannabis, is, 3, f. 

Cantharis, idis, 3, /. 

Capensis, e, 3; adj. 

Capsella, 1. 

Capsicum, 2, 

Capsula, 1. 

Carbo, onis, 3, m. 

Carbolas, atis, 3, m. 

Carbolicus, a, um; adj. 

Carbonas, atis, 3, m. 

Carboneum, 2, 

Carbonicus, a, um; adj. 

Cardamomum, 2. 

Caro, carnis, 3,/. 

Carota, 1. 

Carthamus, z. 

Carum, 2. 

Caryophyllus, 2. 

Cascara Sagrada, L or indecl. 

Cascarilla, 1. 

Cassia, 1. 

Castanea, 1. 

Castoreum, 2. 

Cataplasma, atis, 3, n. 

Cataria, 1. 

Catechu, indecl. 

Catharticus, a, um; adj. 

Caulophyllum, 2. 

Cautchouc, indecl. 

Cedro, indecl. 

Centifolius, a, um; adj. 

Centigramma, 1. 

Centimetrum, 2. 

Cera, 1. 

Cerasus, 2, /. 

Ceratum, 2. 

Ceratus, a, um; adj. 

Cereus, 2. 

Cerevisia, 1. 

Ceriferus, a, um; adj. 






THE PRESCRIPTION. 



Cerium, 2. 

Cetaceum, 2. 
Cetraria, l. 
Chamselirium, 2. 
Chamomilla, 1. 
Charta, l. 
Chartula, 1. 
Chelidonium, 2. 
Chenoyodium, 2. 
Chimaphila, 1. 
Chinoidinum, 2. 
Chionanthus, 2. 
Chirata, l. 
Chloral, is, 3, n. 
Chloralum, 2. 
Chloras, atis, 3, m. 
(liloratus, a, uni; adj. 
Chloridum, 2. 
Chlorinatus, a, urn; odj~ 
Chlorinium, 2. 
Chlorodyna, 1. 
Chloroformum, 2. 
Chondrus, 2. 
Chromicus, a, urn; adj. 
Chrysarobinum, 2. 
Chrysophanicus, a, urn; adj. 
Cicuta, 1 . 
Cigareta, 1. 
Cimicifuga, 1. 
Cina, 1. 
Cinchona, 1. 
Cinchonidina, 1. 
Cinchonina, 1. 
Cinnamomum, 2. 
Citras, atis, 3, m. 
Citricus, a, um; adj. 
Citrus, 2. 
Coca, indecl. 
Cocaina, 1. 
cus, 2. 
Cochlear, is, 3, n. 
Cochlearia, 1. 
Codeina, 1. 
Co flea, 1. 



Colatura, 1. 
Colchicura, 2. 
Collinsonia, 1. 
Collodium, 2. 
Collutorium, 2. 
Collyrium, 2. 
Colocynthis, idis, 3,/. 
Columbo, indecl. 
Communis, e, 3; adj. 
Compositus, a, um; adj. 
Concentratus, a, um; adj. 
Concisus, a, um; adj. 
Confectio, onis, 3,/.; or 

Confectum, 2. 
Congius, 2. 
Conium, 2. 

Contusus, a, um; ad} . 
Convallaria, 1. 
Copaiba, 1. 
Coptis, idis, 3, /. 
Coriandrum, 2. 
Coriaria, 1. 
Cornus, us, 4, /. 
Corrosivus, a, um; adj. 
Cortex, icis, 3, m. 
Corydalis, is, 3, /. 
Coto, indecl. 
Cotula, 1. 
Creasotum, 2. 
Cremor, oris, 3, m. 
Creta, 1. 
Crocus, 2. 
Croton, onis, 3, m. 
Crudus, a, um; adj. 
Cubeba, 1. 
Cuprum, 2. 
Curare, indecl. 
Curcuma, 1. 
Cyanidum, 2. 
Cydonium, 2. 
Cypripedium, 2. 
Damiana, 1. 
Datura, 1. 
Daucus, 2, f. 



LANGUAGE. 



95 



Decigrarama, 1. 
Decimetrum, 2. 
Decoctum, 2; or 

Decoctio, onis, 3,/. 
Delphinium, 2. 
Deocloratus, a, urn ; adj. 
Denarcotisatus, a, urn; adj. 
Depuratus, a, um; adj. 
Despumatus, a, um; adj. 
Destillatus, a, uin; adj. 
Dextrinum, 2. 
Diachylon, 2. 
Dialysatus, a, um; adj. 
Dies, ei, 5, m. or/. 
Digitalina, 1. 
Digitalis, is, 3,/. 
Dilutus, a, um; adj. 
Dimidius, a, um; adj. 
Dioscorea, 1. 
Diospyros, 2. 
Dipterix, igis, 3, /. 
Dita, 1. 
Dosis, is, 3,/. 
Doverus, 2. 
Drachma, 1. 
Dracontium, 2. 
Dragmis, is, 3,/. 
Duboisia, 1. 
Dulcamara, 1. 
Dulcis, e, 3; adj. 
Effervescens, entis, 3; adj. 
Elaterium, 2. 
Elaterinum, 2. 
Elaeosaccharum, 2. 
Electuarium, 2. 
Elemi, indecl. 
Elixir, iris, 3, n. 
Emplastrum, 2. 
Emulsio, onis, 3,/. 
Enema, atis, 3, n. 
Ergota, 1. 
Ergotina, 1. 
Erigeron, ontis, 3, m. 
Eriodyction, 2. 



Erythroxylon, 2. 
Eucalyptus, 2, m. or /. 
Euonymus, 2. 
Eupatorium, 2. 
Euphorbia, 1. 
Euphorbium, 2. 
Expressus, a, um; adj. 
Exsiccatus, a, um; adj. 
Extractum, 2. 
Faba, 1. 
Farina, 1. 

Farinosus, a, um; adj. 
Fel, fellis, 3, n. 
Fermentum, 2. 
Ferratus, a, um; adj. 
Ferricus, a, um; adj. 
Ferrocyanidum, 2. 
Ferrosus, a, um; adj. 
Ferrum, 2. 

Fervidus, a, um; adj. 
Ficus, 2 or 4, /. 
Filix, icis, 3, /. 
Fistula, 1. 
Flavus, a, um; adj. 
Flexilis, e, 3; adj. . 
Florentinus, a, um; adj. 
Floridus, a, um ; adj. 
Flos, floris, 3, in. 
Fluidrachma, 1. 
Fluid uncia, 1. 
Fluid us, a, um; adj. 
Fluigramma, 1. 
Foeniculum, 2. 
Foetidus, a, um; adj. 
Folium, 2. 

Fontanus, a, um; adj. 
Fortis, e, 3; adj. 
Fowlerus, 2. 
Frangula, 1. 
Frankenia, 1. 
Frasera, 1. 
Fructus, us, 4, m. 
Frumentum, 2. 
Fuligo, inis, 3, /. 



08 



THE PRESCRIPTION. 



Fungus, 2. 
Fuscus, a, um; adj. 
Fasus, a, um; adj. 
Galanga, 1. 
Galbanum, 2. 
Galla, 1. 

Gallicus, a, um; adj. 
Gainbogia, 1. 
Gargarisina, atis, 3, n. 
Gaultheria, 1. 
Gelatina, 1. 
Gelsemium, 2. 
Gemma, 1. 
Gentiana, 1. 
Geranium, 2. 
Geum, 2. 
Gillenia, 1. 
Glabrus, a, um; adj. 
Glacialis, e, 3; adj. 
Glucosa, 1. 
Glycerinum, 2. 
Glyceritum, 2. 
Glycyrrhiza, 1. 
Glycyrrhizinum, 2. 
Gossypium, 2. 
Goulardus, 2. 
Gramen, inis, 3, n. 
Gramma, 1 ; or 

Gramma, atis, 3, n. 
Granatum, 2. 
Granulatus, a, um; adj. 
Granulum, 2. 
Granum, 2. 
Grindelia, 1. 
Guaco, indecl. 
Guaiacum, 2. 
Guarana, 1. 
Gummi, indecl. 
Gumrnigutta, 1. 
Gutta, 1. 

Gutta-percha, ae, 1. 
Ihtmatoxylon, 2. 
Haemostaticus, a, um; adj. 
Hamamelis, idis, 3,/. 



Haustum, 2; or 

Haustus, us, 4, m. 
Hedeoma, 1. 
Helenium, 2. 
Heliantbemum, 2. 
Helleborus, 2. 
Helonias, se, 1,/. 
Hepatica, 1. 
Herba, 1. 
Heuchera, 1. 
Hippocastanum, 2. 
Hiruclo, inis, 3,/. 
Hoffmannus, 2. 
Hordeum, 2. 
Humulus, 2. 
Hydrargyrum, 2. 
Hydras, atis, 3, m. 
Hydrastina,. 1. 
Hydrastis, is, 3,/. 
Hydratus, a, um; adj. 
Hydriodas, atis, 3, m. 
Hydriodicus, a, um; adj. 
Hydrobromas, atis, 3, m. 
Hydrobromicus, a, um; adj. 
Hydrochloras, atis, 3, m. 
Hydrochloricus, a, um; adj. 
Hydrocyanicus, a, um ; adj. 
Hydrogenium, 2. 
Hyoscyamina, 1. 
Hyoscyamus, 2. 
Hypophosphis, itis, m. 
Hyposulphis, itis, m. 
Hyssopus, 2. 
Ichthyocolla, 1. 
Idaeus, a, um; adj. 
Ignatia, 1. 
Illicium, 2 6 
Imperatoria, 1. 
Impurus, a, um; adj. 
Incarnatus, a, um; adj. 
Indicus, a, um; adj. 
Indigo, indecl. 
Infusum,2; or 

Infusio, onis, 3, /. 



LANGUAGE. 






Inhalatio, onis, 3,/.; or 
Inhalatus, us, 4, m. 

Injectio, onis, 3,/.; or 
Injectus, us, 4, m. 

Inspissatus, a, urn ; adj. 

Inula, 1. 

Iodatus, a, urn; adj. 

Iodiclum, 2. 

Iodinium 2. 

Iodoformum, 2. 

Iodum, 2. 

Ipecacuanha, 1. 

Iris, idis, 3,/. 

Islandicus, a, um; acZj. 

Jaborandi, indecl. 

Jalapa, 1. 

Jecur, oris, 3, n. 

Juglans, andis, 3,/. 

Juniperus, 2,/. 

Kali, indecl., n. 

Kalium, 2. 

Kamala, 1. 

Kava Kava, indecl. 

Kino, indecl. 

Koumiss, indecl. 

Kousso, indecl. 

Kramer ia, 1. 

Lac, lactis, 3, n. 

Lactas, atis, 3, m. 

Lacticus, a, um; adj. 

Lactuca, 1. 

Lactucarium, 2. 

Lagena, 1. 

Laminaria, 1. 

Lanolinum, 2. 

Laudanum, 2. 

Lapis, idis, 3, m. 

Lappa, 1. 

Laurocerasus, 2,/. 

Laurus, 2 or 4,/. 

Lavamentum, 2. 
^Lavandula, 1. 

Lavatura, 1. 
Leonurus, 2. 



Leptandra, 1. 
Levisticum, 2. 
Lex, legis, 3, /. 
Libra, 1. 
Libitum, 2. 
Lichen, inis, 3, m. 
Lignum, 2. 
Limatura, 1. 
Limon, is, 3, /. 
Limonia, 1. 
Linctus, us, 4, m. 
Linimentum, 2. 
Linum, 2. 

Liquidus, a, um; adj. 
Liquiritia, 1. 
Liquor, oris, 3, m. 
Liriodendron, 2. 
Lithium, 2. 
Lobelia, 1. 
Lotio, onis, 3, /. 
Lotus, a, um; adj. 
Lupulinum, 2. 
Lupulus, 2. 
Lycopodium, 2. 
Lycopus, odis, 3; or 2, m. 
Lytta, 1. 
Macis, idis, 3,/. 
Madeirensis, e, 3; adj. 
Magma, atis, 3, m. 
Magnesia, 1. 
Magnesium, 2. 
Magnolia, 1. 
Maltum, 2. 
Manganum, 2. 
Mangostana, 1, 
Manna, 1. 
Manzanita, 1. 
Maranta, 1. 

Marilandicus, a, um; adj. 
Marrubium, 2. 
Mas, aris, 3, m. 
Massa, 1. 
Mastiche, es, 1,/. 
Matico, indecl. 



98 



THE PRESCRIPTION. 



Matricaria, 1. 
Mays, dis, 3,/.,* or 

Mais, indecl. 
Medulla, 1. 
Mel, mellis, 3, n. 
Melilotus, 2. 
Melissa, 1. 
Mellitum, 2. 
Melo, onis, 3,/. 
Menispermum, 2. 
Mentha, 1. 
Menthol, is, 3, m. 
Menyanthes, £e, 1, /. 
Methysticum, 2. 
Metrum, 2. 
Mezereum, 2. 
Mica, 1. 
Micromeria, 1. 
Mikania, 1. 
Millefolium, 2. 
Milligram ma, 1. 
Millimetrum, 2. 
Mindererus, 2. 
Minimum, 2. 
Mistura, 1. 
Mitchella, 1. 
Mitis, e, 3; adj. 
Monarda, 1. 
Monesia, 1. 

Monobromatus, a, urn; adj. 
Morphia, 1. 
Morphina, 1. 
Morrhua, 1. 
Morum, 2. 
Moschus, 2. 
Moxa, 1. 

Mucilago, inis, 3, /. 
Mucuna, 1. 
Murias, atis, 3, m. 
Muriaticus, a, um; adj. 
Myrcia, 1. 
Myrica, 1. 
Myristica, 1. 
Myrotheca, 1. 



Myrrha, 1. 
Narcotina, 1. 
Natrium, 2. 

Natronatus, a, um; adj. 
Nectanclra, 1. 
Nicotina, 1. 
Niger, gra, grum; adj. 

(Gen. of niger is nigri.) 
Nitras, atis, 3, m, 
Nitricus, a, um; adj. 
Nitris, itis, 3, m. 

Nitrohyclrochloricus, a, um; adj. 
Nitromuriaticus, a, um; adj. 
Nitrosus, a, um; adj. 
Nux, nucis, 3,/. 
Nymphaea, 1. 
Octarius, 2. 
Odoratus, a, um; adj. 
Oleas, atis, 3, m. 
Oleatum, 2. 
Oleoresina, 1. 
Oleum, 2. 
Oliva, 1. 
Olla, 1. 
Opium, 2. 
Opodeldoc, indecl. 
Optimus, a, um; adj. 
Opulus, 2, /. 
Oregonensis, e, 3; adj. 
Origanum, 2. 
Oryza, 1. 
Os, ossis, 3, n. 
Ovum, 2. 

Oxalas, atis, 3, m. 
Oxalicus, a, um; adj. 
Oxidum, 2. 

Oxycroceus, a, um; adj. 
Oxymel, mellis, 3, n.; or 

Oxymeli, itis, 3, n. 
Pallidus, a, um; adj. 
Pancreatinum, 2. 
Panis, is, 3, m. 
Papaver, eris, 3, n. 
Papaya, 1. 



LANGUAGE. 



99 



Paraffinum, 2. 
Paregoricum, 1. 
Pareira, 1, 
Pars, partis, 3,/. 
Parvulum, 2. 
Pasma, atis, 3, n. 
Passa, 1. 
Pastilla, 1. 
Paullinia, 1. 
Pauper, eris, 3; adj. 
i Pepo, onis, 3, m. 
i Pepsinum, 2. 
i Perforatus, a, urn; adj. 
Permanganas, atis, 3, m. 
. Peroxidum, 2. 
Peruvianus, a, um; adj. 
\ Pessarium, 2 ; or 

Pessum, 2. 
Petrolatum, 2. 
Petroleum, 2. 
Petroseliuum, 2. 
Phiala, 1. 
Phoradeudrou, 2. 
Phospbas, atis, 3, m. 
Phosphis, itis, 3, m. 
Phosphoratus, a, um; adj. 
Phosphoricus, a, um; adj. 
Phosphorus, 2. 
Physostigma, atis, 3, n. 
..Physostigmiua, 1. 
Phytolacca, 1. 
jPicricus, a, um; adj. 

Picrotoxinum, 2. 

Pilocarpi na, 1. 

Pilocarpus, 2. 

Pimenta, 1. 

Pinus, 2 or 4, /. 

Piper, eris, 3, n. 

Piperina, 1. 

Piperitus, a, um; adj. 

Piscidia, 1. 

Pix, picis, 3,/. 

Plumbum, 2. 

Podophylliuum, 2. 



Podophyllum, 2. 
Pollen, iuis, 3, n. 
Polygala, 1. 
Polygonum, 2. 
Polypodum, 2, 
Pomatum, 2. 
Pomatus, a, um; adj. 
Populus, 2,/. 
Porcus, 2. 
Portensis, e, 3; adj. 
Potassa, 1. 
Potassium, 2. 
Potio, onis, 3,/.; or 

Potus, us, 4, m. 
Praecipitatus, a, um; adj. 
Praeparatus, a, um; ac/j. 
Praescriptum, 2; or 

Praescriptio, onis, 3, /. 
Precatorius, a, um; adj. 
Prinos, 2. 
Propylamina, 1. 
Protochloridum, 2. 
Protoiodidum, 2. 
Prunifolius, a, um; adj. 
Prunum, 2. 
Prunus, 2,/. 
Ptelea, 1. 
Pulpa, 1. 
Pulsatilla, 1. 
Pulvis, eris, 3, m. or/. 
Purificatus, a, um; adj. 
Purus, a, um; adj. 
Pyrethrum, 2. 
Pyrogallicus, a, um; adj. 
Pyrolignicus, a, um; adj. 
Pyrophosphas, atis, 3; m. 
Pyrophosphoricus, a, um; adj. 
Pyroxylinum, 2; or 

Pyroxylon, 2. 
Quassia, 1. 
Quebracho, indecl. 
Quercus, us, 4,/. 
Quillaia, 1. 
Quinia, 1. 



100 



THE PRESCRIPTION. 



Quinidia, 1. 
Quinina, 1. 

Quinquefolius, a, urn; adj. 
Radix, icis, 3,/. 
Ranunculus, 2. 
Recens, ntis, 3; adj. 
Receptum, 2. 
Rectificatus, a, urn; adj. 
Redactus, a, am; adj. 
Resina, 1. 

Rhamnus, 2, /. or hi. 
Rhatanha, 1. 
Rheum, 2. 

Rhus, rhois, m. or/. 
Ricinus, 2. 
Roob, is, 3, n.; or 

Roob, indecl. 
Rosa, 1. 
Rosmarinus, 2. 
Rottlera, 1. 
Rotula, 1. 
Rubella, 1. 
Ruber, bra, brum; adj. 

(Gen. of ruber is rubn.) 
Rubia, 1. 
Rubus, 2. 

Rumex, icis, 3, m. or/. 
Ruta, 1. 
Sabadilla, 1. 
Sabbatia, 1. 
Sabina, 1. 

Saccharatus, a, um; adj. 
Saccharam, 2. 
Sago, indecl. 
Sal, salis, 3, n. or m. 
Salep, indecl. 
Salicylas, atis, 3, m. 
Salicylicus, a, urn; adj. 
Salicinum, 2. 
Salix, icis, 3,/. 
Salvia, 1. 
Sambucus, 2. 
Sauguinaria, 1. 
Santalum, 2. 



Santonica, 1. 
Santoninas, atis, 3, m, 
Santoninum, 2. 
Sapo, onis, 3, m. 
Sarsaparilla, 1. 
Sassafras, indecl. 
Sativus, a, urn; adj. 
Saturatio, onis, 3, /. 
Scammonium, 2. 
Scatula, 1. 
Scilla, 1. 
Scoparius, 2. 
Scrupulus, 2. 
Scutellaria, 1. 
Secale, is, 3, n. 
Sedimentum, 2. 
Semen, inis, 3, n. 
Semidrachma, 1. 
Semissis, e, 3; adj. 
Senega, 1. 
Senna, 1. 

Sericus, a, um; adj. 
Sericum, 2. 
Serpentaria, 1. 
Serrulatus, a, um; adj. 
Sesamum, 2. 
Sesquichloridum, 2. 
Sevum, 2. 
Simaruba, 1. 
Simplex, icis, 3; adj. 
Sinapis, is, 3,/. 
Socotrinus, a, um; adj. 
Soda, 1. 
Sodium, 2. 
Solidago, inis, 3,/. 
Solubilis, e, 3; adj. 
Solutio, onis, 3,/, 
Sparadrapum, 2. 
Species, ierum, pi., 5,/. 
Spermaceti, indecl, 
Spigelia, 1. 
Spiraea, 1. 
Spiritus, us, 4, m. 
Spongia, 1. 



LANGUAGE. 



101 



Statice, es, 1,/. 
Stibium, 2. 
Stigma, atis, 3, n. 
Stillingia, 1. 
Stramonium, 2. 
Strychnia, 1. 
Strychniua, 1. 
Stypticus, a, urn; adj. 
Styrax, acis, 3, m. or/, 
Subacetas, atis, 3, m. 
Subcarbonas, atis, 3, m. 
Sublimatus, a, um; adj. 
Subnitras, atis, 3, m. 
Subsulpbas, atis, 3, m. 
Succinum, 2. 
Succus, 2. 
Sulphas, atis, 3, m. 
Sulphis, itis, 3, Jn. 
Sulphocarbolas, atis, 3, m. 
Sulphur, is, 3, n. 
Sulphuratus, a, um; adj. 
Sulphuretus, a, um; adj. 
Sulphuricus, a, um; adj. 
Sulphurosus, a, um; adj. 
Sumbul, indecl. 
Suppositorium, 2. 
Syriacus,-a, um; adj. 
Syrinx, ngis, 3,/. 
Syrupus, 2. 
Tabacum, 2. 
Tabella, 1. 
Tamarindus, 2. 
Tanacetum, 2. 
Tannicus, a, um; adj. 
Tanninum, 2. 
Tapioca, 1. 
Taraxacum, 2. 
Tartaricus, a, um; adj. 
Tartras, atis, 3, m. 
Tepidus, a, um; adj. 
Terebinthina, 1. 
Tersulphas, atis, 3, m. 
Testa, 1 . 
Thea, 1. 



Thebaicus, a, um; adj. 
Theina, 1. 

Theobroma, atis, 3. n. 
Theriaca, 1. 
Thuja, 1. 
Thymol, is, 3, m.; or 

Thymolum, 2. 
Thymus, 2. 
Tiglium, 2. 
Tilia, 1. 

Tinctorius, a, um; adj. 
Tinctura, 1. 
Tolu, indecl. 
Tolutanus, a, um; adj. 
Tonco, indecl. 
Tonga, 1. 
Tormentilla, 1. 
Tostus, a, um; adj. 
Toxicodendron, 2. 
Tragacantha, 1. 
Trifolium, 2. 
Trillium, 2. 
Triosteum, 2. 
Triticum, 2. 
Trituratio, onis, 3,/. 
Trochiscus, 2. 

Truncus, 2. 
Tuber, eris, 3, ».• 
Tuberosus, a, um; adj. 

Tussilago, inis, 3, /. 

Ulmus, 2,f. 

Uncia, 1. 

Unguentum, 2: or 
Unguen, inis, 3, n. 

Urari, indecl. 

Ursus, 2. 

Urtica, 1. 

Ustilago, inis, 3,/. 

Ustus, a, um; adj. 

Uva, 1. 

Valeriana, 1 , 

Valerianas, atis, 3, m. 

Valerianicus, a, um: adj. 

Vanilla, 1. 



102 



THE PRESCRIPTION. 



Vaselinum, 2. 
Vegetabilis, e, 3; adj. 
Yenalis, e, 3; adj. 
Yeratria, 1. 
Veratrina, 1. 
Ve rat rum, 2. 
Yerbascum, 2. 
Veronica, 1. 
Versicolor, oris, 3; adj. 
Vesicatorius, a, urn; adj. 
Yesicatorium, 2. 
Yesiculosus, a, um; adj. 
Viburnum, 2. 
Viola, 1. 
Vinum, 2. 

Virginianus, a, um ; adj. 
Virginicus, a, um; adj. 
Viridis, e, 3; adj. 
Virosus, a, um; adj. 
Viscum, 2. 
Vitellus, 2. 
Vitrum, 2. 



Volatilis, e, 3; adj. 
Yomicus, a, um; adj. 
Vulgaris, e, 3; adj. 
Vulnerarius, a, um; adj. 
Warburgus, 2. 
Wintera, 1. 
Woorari, indecl.; or 

Woorali, indecl. 
Xanthorrhiza, 1. 
Xanthoxylum, 2. 
Xericus, a, um; adj. 
Xerium, 2. 
Yerba Buena, 1.* 
Yerba Mansa, 1.* 
Yerba Beuma, 1.* 
Yerba Santa, 1.* 
Zea, 1. 
Zedoaria, 1. 
Zeylanicus, a, um; adj. 
Zingiber, eris, 3, n. 
Zincum, 2. 
Zizyphus, 2, /. 



Verbs. 



But few verbs are used in prescriptions, and these, with few excep- 
tions, only in the imperative mood, so that it is not necessary to de- 
scribe the conjugations at all, and it will be sufficient to merely 
mention the verbs in the forms in which they are used. The follow- 
ing list includes the most important. The number after the verb re- 
fers to the number of the conjugation: 

Adde. — Active voice, imperative mood, present tense, and singular 
number of the verb addo, 3. It means "add," and is followed by the 
accusative case. 

Cola. — Active voice, imperative mood, present tense, and singular 
number of the verb colo, 1. It means " strain." 

Consperge. — Active voice, imperative mood, present tense, and sin- 
gular number, of the verb conspergo, 3. It means "sprinkle," and is 
used, for example, in prescriptions for pills, to designate the powder 
with which the pills are to be rolled. It is an active verb, and its 
object (the thing to be sprinkled) is placed in the accusative case, 

* These are Spanish names, both words of which are either treated in pre- 
scriptions like Latin words of the first declension, or may be considered in- 
declinable. 



LANGUAGE, 



103 



followed by the ablative of the substance with which it is sprinkled. 
In prescriptions, however, the object is generally omitted or under- 
stood, and the verb is followed by the ablative of the conspergative. 
In English we might say " sprinkle the pills with lycopodium," or 
" sprinkle lycopodium on the pills." In Latin the first form is gener- 
ally used, and we would write " consperge pilulas lycopodio," or «co?i- 
sperge (pilulas understood) lycopodio." In the last form the verb is, 
of course, only apparently followed by the ablative. 

Da.— Active voice, imperative mood, present tense, and singular 
number of the verb do, 1. It means " give." 

Datus, a, urn.— Participial adjective of the same verb; means 
f l given." 

Detur, singular; and 

Dentur, plural.— Passive voice, subjunctive mood, present tense, 
third person, singular and plural respectively, of the same verb. 

These words mean " let be given." The subject, or thing to be 

given is placed in the nominative, singular or plural as the case 
may be. 

Divide. — Active voice, imperative mood, present tense, and singular 
number of the verb divido, 3. It means " divide," and is usually fol- 
lowed by the preposition in and the accusative case. 

Fiat, singular; and 

Fiant, plural. — The verb fio is an irregular passive verb, active in 
form, but passive in meaning. It is used as the passive of facio, 3, I 
make. It, therefore, means, "I am made," or, in the infinitive, "to be 
made." The forms in which it is used are the subjunctive mood, 
present tense, and third person, singular and plural. The thing or 
things to be made are placed in the nominative case. Fiat and fiant 
means "let be made," the dash meaning the proper subject, sin- 
gular or plural, as the case may be; thus : fiat emulsio means " let an 
emulsion be made;" fiant pilulce XII means "let twelve pills be 
made." 

Misce. — Active voice, imperative mood, present tense, and singular 
number of the verb misceo, 2. It means " mix." 

Misceantur — Passive voice, subjunctive mood, present tense, third 
person, and plural number of the verb misceo, 2. It means "let 
(them) be mixed." 

Obducantur — Passive voice, subjunctive mood, present tense, third 
person, plural number of the verb obdaco, 3. The word means "let 
(them) be coated," and is used in formulae for pills. The substance 
with which the pills are to be coated is put in the ablative ; for in- 
stance: Pilulce foliis auri obducantur, let the pills be coated with gold- 
leaf (literally, with leaves of gold) . 

Becipe.— Active voice, imperative mood, present tense, and singular 



104: THE PRESCRIPTION. 

number of the verb recipio, 3. Means " take," and is followed by the 
accusative of the thing or things to be taken. 

Bepete. — Active voice, imperative mood, present tense, and singular 
number of the verb repeto, 3. It means "repeat" or "renew," and 
is followed by the accusative. 

Signa. — Active voice, imperative mood, present tense, and singular 
number of the verb signo, 1. It means " label." 

Solve. — Active voice, imperative mood, present tense, and singular 
number of the verb solvo, 3. It means "dissolve." 

Tere. — Active voice, imperative mood, present tense, and singular 
number of the verb tero, 3. It means " rub " or "triturate." 

To recapitulate, we have the following table of verbs and the usual 
abbreviations in parentheses, followed by the meaning in English. 
Where no abbreviation is given, it means that the word is usually 
written out in full. 

Latin. English. 

Adde add. 

Cola strain. 

Consperge (consp.) sprinkle. 

Da (d.) give. 

Detur (d.) let (it) be given. 

Dentur (d.) let (them) be given. 

Divide (div.) divide. 

Fiat (ft.) ......let (it) be made. 

Fiant (ft.) let (them) be made. 

Misce (in.) mix. 

Misceantur (m.) let (them) be mixed. 

Obducantur let (them) be coated. 

Recipe flfc) take. 

Bepete ; repeat ; renew. 

Signa (s.) * label. 

Solve dissolve. 

Tere rub ; triturate. 

Adverbs. 

Ana, usually written aa, means " of each." When equal quantities of 
several consecutive ingredients of a prescription are to be dispensed, 
this adverb is placed after the name of the last of these ingredients 
and before the quantity. 

Quantum satis, usually abbreviated to q. s., consists of two adverbs, 
quantum (" as much as ") and satis (" enough"), both together mean- 
ing " as much as will suffice," or " as much as may be necessary," or 



LANGUAGE. 



103 



simply " enough. " Sometimes q. s. is said to be " quantum sufficit " 
(not sufficiat), which, however, means the same thing, sufficit being a 
verb meaning "it suffices. " It will be simplest always to read q. s. as 
quantum satis. The name of the drug must be in the genitive. 
The use of q. s. will be considered further on. 

Parts of Prescription. 

The prescription is divided into several parts, each of which is dis- 
tinct from the others. These parts are: First, the superscription, or 
order to "take," usually consisting of the sign ]$.; second, the in- 
scription, or enumeration of the ingredients; third, the subscription, 
or directions to the pharmacist how to compound; and fourth, the 
signature, or direction for labeling. 

We will consider these parts more in detail a little further on. 

Construction of Prescription. 

To recapitulate in regard to the grammatical form of the prescrip- 
tion, we remark that it commences with the imperative " take " (r£), 
which is followed by the genitive of the name of the substance and 
the accusative of the quantity, thus : 

Superscription — $ . 

Inscription— Remedy (gen.). Quantity (ace). 

(Repeat for each ingredient.) 
Subscription— Misce (etc.). 
Signature— Signa (etc.). 

It is to be remembered, however, that only the nominatives of an 
official or pharmaceutical name are to be changed to the genitive, all 
other words of the official names remaining unchanged, as, for in- 
stance, if we order hydrargyrum cum creta, only the first word is 
changed to the genitive, the ablative creta following cum remaining as 
it is. Moreover, the nominative of the official title is changed -to the 
genitive only when a certain quantity (grains, drams, ounces, grams, 
-etc.) is ordered. 

When no quantity, but a certain number, is ordered, as occasionally 
in prescriptions for pills, the number is expressed by a numeral adjec- 
tive, and the object of the verb recipe then is the substance or remedy 
which must accordingly be placed in the accusative case, as when we 
write. 

R— Pilulas catharticas, viii. 
Signa, etc. 



106 THE PRESCRIPTION. 

We may have both constructions in the same prescription, a$, for in- 
stance : 

R— Chloroformi, f 3 i. 

Olei morrliuae, f 5 i- 

Vitellum ovi, i. 

Syrupi sacchari, f 5 i- 
Aquam puram, ad f § vi. 
Misce. Fiat emulsio. Signa. 

It will be noticed that when a quantity is ordered, the nominative of 
the title of the remedy is changed to the genitive; otherwise the nom- 
inative changes to the accusative, as when one yolk of egg is ordered 
or when enough water is prescribed to make 6 fluidounces. 

Nomenclature. 

In constructing the nomenclature of any science, one object should 
be to convey as much information as possible in the names adopted. 
In botany, for instance, we find names of genera which convey cer- 
tain ideas concerning the plant. Digitalis is a name derived from the 
Latin word digitus — a finger — and the name as applied to the plant 
refers to the thimble-like shape of the flower. The English word fox- 
glove, and the German word Jingerhut, have similar significance, and 
other languages have words of like meaning. It need not, however, 
be supposed that these names have been independently invented by 
persons in different countries, but they probably are all derived from 
the conceit of the first one who gave the Latin name. Or the name 
may suggest the history of the plant, as is the case with cinchona,, 
which is named in honor of the Countess of Chinchon, and the name 
recalls all of the romantic history of the conquest of Peru to any one 
who has ever read about it. Or the plants are named in honor of great 
men, as " Wellingtonia," " Traclescantia," etc. Often it is the spe- 
cific name which gives the desired information: Cinchona macroca- 
lycis, cinchona with the large calyx; Digitalis purpurea, the purple- 
colored digitalis; Cassia acutifolia, cassia with the acutely pointed 
leaf, etc. Among animals the Physeter macrocephalus may serve as an 
example of the same general truth. 

Who that has studied chemistry does not know that the names of 
chemicals convey the knowledge of their composition; that a sul- 
phate, for instance, is a compound of a base with sulphuric acid. 
And so in every branch of science, in proportion as it approaches per- 
fection its nomenclature becomes more exact, and the science is more 
easily mastered by the student. 

It is true that occasionally names become attached to certain things, 
and that it is afterwards difiicult to change the names when they cease 
to convey correct information. For example, Oidium abort) faciens — 



LANGUAGE. ]l,7 

literally, the abortion-making oiclium— was so named because it was 
thought to be the cause of the abortion of the ovule of rye and the 
production of ergot. Now we know that it has nothing to do with the 
formation of the ergot, and, besides, the latter is not an aborted rye 
grain at all, so that the specific name is wrong in all its parts, but it 
still continues to be used. 

In other cases the names change as knowledge advances. Cinchona 
was first known as pulvis de la comtessa, because the Countess of Chin- 
chon introduced it to the notice of the old world; as pulvis patrum 
or pulvis Jesuiticus, because first sold by the Jesuit fathers. A certain 
variety is even to this day spoken of as " Crown Bark," because it was 
considered a couple of centuries ago to be the best bark, and its sale 
was a prerogative of the Spanish crown. But these names gradually 
fell into disuse as the knowledge in regard to this drug and its 
sources widened. It seems to me that some of the principles which 
govern the development of scientific nomenclature in other branches 
of human thought and activity might well be applied to our pharma- 
ceutical nomenclature, which is now lamentably imperfect. For in- 
stance, the present pharmacopoeia! name Iris conveys no information 
at all. The name does not tell us what the drug is, or from what it is 
derived; whether it is a root, rhizoma, leaves, flowers, or what else. 
And, moreover, it does not refer to the same drug Iris which was for- 
merly used. The name should, as far as possible, give us the above 
information. 

In the Pharmacopoeia of 1870 extractum aconiti meant an extract of 
the leaves, while in that of 1880 the same name means an extract of 
the root. When a physician who is behind the times prescribes this 
preparation he probably means the extract of aconite leaves, and if it 
comes to be dispensed by a pharmacist who is up with the times he 
ought to, and probably will, dispense the extract of aconite root, and 
the patient takes five times as strong a dose as was intended, and pos- 
sibly dies a victim to imperfect nomenclature. 

The United States Pharmacopoeia simply ignores all remedies not 
contained in itself, and bases its nomenclature on the idea that only 
that part of a plant is used which it recognizes. As a matter of fact, 
however, the part recognized by the Pharmacopoeia is often not the 
part of the plant most generally employed, as we see in Calendula. 
Formerly this meant the flowers, now it means the herb or flowering 
tops; but, although the herb is official, the flowers continue to be 
commonly employed. 

All modern systems of pharmacognosy are based on the structural 
characteristics of the drugs, and these should, therefore, be the base 
for our nomenclature. When we speak of rhubarb, for example, the 
name should tell us that the drug i« + he root, and so on. But it be- 



108 THE PRESCRIPTION. 

comes an interesting question for discussion whether we should say 
radix rhei or rhei radix, or whether we should use the singular radix 
or the plural radices; also, whether the singular or plural of the origin 
of the drug shall be used in such names as oleum olivce or oleum oli- 
varum, etc. The question in regard to plural or singular has been 
settled by common cousent in favor of the singular, and, as this is no 
doubt correct practice, we will not stop to discuss it now. But some- 
thing may be said in regard to the precedence of words in the title. 
Shall the plant name be first and the plant part second, or vice versa") 
This question involves some points of interest to which it may be well 
to devote a few words of discussion. It involves, in the first place, the 
consideration of the idiomatic construction of languages. In French 
we £ay, for instance, l( une femme charmante" — a woman charming — 
while in English we say, " a charming woman." 

If we analyze the mental process of the conveyance of ideas by 
means of words, it seems that the French method is not as good as 
the English. Thought is instantaneous and so rapid in its action that 
often a person who supposes himself to be drowning reviews his whole 
life, with all its good and evil deeds, in the few seconds of submersion 
before he is rescued. Therefore, when the Frenchman says "the 
woman charming" the mind, hearing the word "woman" (femme), 
may think of the structural and physiological features which consti- 
tute the woman, and may think of all kinds of women, of all times and 
all nations, from Xantippe to Florence Nightingale, and from the 
naked Papuan to the brilliant society queen, before the following 
word (charmante) calls the mind back to the idea conveyed by that word, 
and all the other involuntary and irrelevant mental suggestions must 
be eliminated in order to limit the idea to the conception of one kind 
of woman only — the charming woman. In English or German, on the 
other hand, the adjective conjures up an abstract idea, and when the 
noun follows, the total idea is much more clearly defined, and the ideas 
are impressed with a vigor and clearness that seem to be impossible 
with the French construction. 

In Latin also, the adjective is generally placed before the noun to 
which it belongs, as in English and German. 

Now, apply this to our drugs. Shall we say radix rhei, or rhei 
radix ? 

Badix rhei is the French construction in effect. The mention of the 
word radix suggests so many facts regarding structure, etc., that it 
takes an effort of the mind to limit the idea to the conception of the 
single root derived from rhubarb. On the other hand, rhei radix will 
suggest rhubarb alone to the mind, and it is no effort at all to form 
an idea of the root of that plant alone. Our nomenclature should, 
therefore, include the name of the part of the plant, and such names 



LANGUAGE. 109 

as aconiti radix, sennai folium, arnicceflos, maydis stigma, cinchona: cor- 
tex, would be preferable to radix aconiti, folium sennai, etc. This 
method of nomenclature has been adopted in this work, and exam- 
ples of it, as applied to pharmaceutical preparations, may be seen in 
the enumeration of the fluid extracts, tinctures, etc., in the earlier 
pages of this book. 

Another advantage gained by a nomenclature constructed as above 
explained is, that if we know the name of the plant we can find ref- 
erences in the dispensatories, etc., in alphabetical order, and if the 
names of the preparations are constructed in the same manner we 
gain the advantage that the description of the drug, and of all of its 
preparations will be found in one place, and in alphabetical order.* 

For instance, referring to aconiti radix, we will find abstract, ex- 
tract, fluid extract, liniment, tincture, etc., all together. A mere 
glance will tell the physician not only that it is aconite, but that it is 
the root of aconite, and it will also suggest all the different forms in 
which he may prescribe it. The name suggests volumes of informa- 
tion, and both pharmacists and physicians must become better ac- 
quainted with the materia medica. If a glance at the Pharmacopoeia 
will give all this information, it becomes desirable that every physi- 
cian should have a copy of that work. With the present nomencla- 
ture and arrangement, the Pharmacopoeia is of comparatively little 
use to the doctor. 

When their knowledge of materia medica is increased, physicians 
will prescribe more simples, and the arts of prescribing and com- 
pounding will receive an impetus which they can not receive in any 
other manner. The unfamiiiarity of physicians with the articles of 
the materia medica and with the preparations accounts for many of 
the unsatisfactory conditions of both of the medical professions. 

Since a proper nomenclature will aid in a better knowledge of phar- 
macognosy and pharmacy, it is certainly desirable that pharmaceutical 
nomenclature should be made commensurate with the advancements 
of our professions in other matters. 

Abbreviations. 

Although it is best to write out all the words of a prescription in 
lull, there can be no serious objection to the almost universal habit of 
abbreviating the names of the ingredients. Several objects are aimed 
at and gained by using these abbreviations. We avoid the trouble of 
learning the Latin case endings; we save time and trouble, and often 

*See, for instance, the arrangement adopted to the ''Companion to the 
United States Pharmacopoeia," by Professors Oscar Oldberg, Ph. D., and 
Otto A. Wall, M. D., Ph. G. 



HO THE PRESCRIPTION. 

make the prescription even more readable to the druggist than when 
written out in full. 

Another, and by no means slight, reason for abbreviating is that the 
prescription written in abbreviations becomes even less intelligible to 
the public than a Latin prescription written out in full, and in cases 
where it is desirable to keep the patient in ignorance of the remedy 
he is taking proper abbreviations may contribute materially to this 
result. In this connection it may be well to remind druggists that 
they often injure the physician, the patient, and themselves by enter- 
ing into explanations to an inquisitive customer in regard to the in- 
gredients of a prescription. If any such explanations are to be made 
they can be made by the physician, and certainly should not be made 
by the druggist. The physician does not like this meddling with his 
affairs any more than the druggist likes the physician to tell the pa- 
tient the intrinsic value of the ingredients of the prescription. 

But the above advantages are only gained by using proper abbre- 
viations, by which we mean such as can not, under any circumstances, 
be construed to mean anything else than what they were intended for 
by the writer of the prescription. 

We may assert, as an axiom, that no abbreviation is correct in a 
prescription which would not allow us to recognize the word if it 
stood alone, even though the context may enable us to guess what 
the w T ord should be. Such an abbreviation as hydr. chlor. cor. could 
not well mean anything but corrosive chloride of mercury, and yet 
all three of these abbreviations are improper, because none of them' 
could be recognized if standing alone. Hyd. chl. or hydr. chlor., of 
course, are w T orse still, because here the context will not allow us to 
guess whether hydrate of chloral or one of the chlorides of mercury 
is wanted. 

The rules which apply in English for dividing a word when part of 
it is at the end of one line and part at the beginning of the next line 
apply in Latin as well, and an abbreviation should usually be made 
by simply dropping the terminal syllable. 

A rule for abbreviating may be stated as follows: 

Ascertain the root of the word and then abbreviate by dropping all let- 
ters after the last consonant in the root and place a period after this abbre- 
viation. 

Thus, the root of the w r ord bismuthum is bismuth, and the last con- 
sonant is h; we therefore place a period after this letter and have the 
abbreviation bismuth., which is, of course, just as plain as if we wrote 
bismuthi out in full. The root of the word potassium is potassi, the last 
consonant of which is the second s, at which we abbreviate, and af- 
ter which we place the period, thus obtaining potass, as the abbrevia- 
tion. This rule, however, requires a knowledge of the declension of 



LANGUAGE. 



Ill 



words, especially those of the third declension, and a merely mechan- 
ical rule may be used to accomodate those who do not know an< 
not care to learn the method of ascertaining the roots of Latin w< 
Such a rule might be stated as follows: 

From the words of the official or officinal names drop the endings so that 
the last letter retained is a consonant ichich immediately precedes a vowel. 
Place a period after this consonant. 

As an illustration take the official name hydrargyri iodidum viride; 
dropping i and retaining as last letter the r, which is a consonant im- 
mediately preceding a vowel, we have hydrargyr. as the abbreviation. 
Abbreviating further by dropping r, we must also drop y, so that g is 
the last letter, as this is the next consonant immediately preceding 
a vowel, and our abbreviation is hydrarg., which is as short as we 
ought to abbreviate, because the next abbreviation would be hydr., and 
this would not necessarily mean mercury if it stood alone. According 
to the same rule iodidum is abbreviated to iodid., and viride to virid., 
and our abbreviation for the whole title would be hydrarg. iodid. 
virid. 

The above rule being merely mechanical, is not quite sufficient in all 
cases. A few 7 words are so short that they can not be intelligibly ab- 
breviated at all, as rheum, opium, cera, and some others. Fortunately 
most of these short words are of either the first or second declen- 
sions, and it is easy to write their genitives. A few, however, like 
pix, calx, etc., are of the third declension, and here we must learn the 
genitives or transgress against the rules of Latin grammar and be 
content to write the nominative ; or we change the final x to c and 
place a period after it when we have the abbreviation of the genitive, 
thus: Pic. is an abbreviation of picis; calc, of calcis. But here again 
we stumble over the difficulty that in some words the vowel preceding 
final x is changed in the genitive, as in cortex and rumex, of which the 
genitives are corticis and rumicis; etc. There are still other words to 
which this mechanical rule will not apply, as aloe, genitive aloes; 
adeps, genitive adipis; etc. 

The only way, therefore, of correctly abbreviating in all cases is to 
study Latin sufficiently to be able to also correctly write out the 
names in full, for, according to any other plan, incorrect abbreviations 
will occasionally creep in. 

By long-established custom some incorrect abbreviations may be 
tolerated, as when we write sulph., which always means sulphas, or 
sulphate. It is true that it might be an abbreviation of sulphis, sul- 
phidum, etc., but by usage the whole world over sulph. means the sul- 
phate, and the other words must be distinguished by writing out in 
full, or, at least, by a different abbreviation. A common error is to 
abbreviate sulphas, or sulphatis, to sul. This is always inelegant and 



H2 THE PRESCRIPTION. 

wrong. Such abbreviations as sulp. for sulph., phosp. for phosph., are 
also quite common ; and in regard to them it should be remembered 
that ph in these words represents one sound— the sound of /. It does 
not, therefore, represent two letters, but only one, and can not be 
separated in this class of words. 

It is not possible to mention all the inelegant or incorrect abbrevia- 
tions in common use, such as pot. for potassium; hg., hyd.> and hydr. 
for hydrargyrum; cp. and co. for compositus, etc., for they are legion. 

Some of these, it is true, have the sanction of long usage in their 
favor and should, perhaps, not be called wrong on that account; such 
are, for instance: co. or cp. for compositus; fl. or fld. for fluidus; plv. 
for pulvis; spl. for simplex; sp., spt., or spts. for spiritus; tr. for tine- 
tura; and ugt. or ungt. for unguentum, etc. 

The extremes of brevity to which abbreviations are sometimes car- 
ried may be seen from the following, which are a very few of those 
quoted as proper in a well-known medical work.* 

C. G Cucurbitula omenta (cupping glass) . 

C. C Cornu cervi (hart's horn) . 

C. C. U Cornu cervi ustum (burnt hart's horn) . 

O. O. O Oleum olivce optimum (best olive oil) . 

P. B. jV Pro re nata (according to circumstances) . 

Q. Q. H Quaqua quarta hora (every four hours) . 

Q. P Quantum placet (as much as you please) . 

T. Tinctura opii (tincture of opium) . 

To use such abbreviations, especially when they refer to such pow- 
erful preparations as opium tincture, is to trifle with human life, and 
if an accident occurred in consequence it should be ascribed to crim- 
inal carelessness. 

A peculiar method of abbreviation is used in some parts of Europe. 
It is to contract the word to its most important consonants and end 
with the proper vowel endings, so that tinctura (nominative) is 
changed to Tra, and tincturce (genitive) to Trae. No period is placed 
after these abbreviations, and unless known the names might appear 
strange. For instance: 

R— Trae nuc. vomic, f 5 i. 

Trae cinchon. comp., f 3 vii. 
M. S.: 15 drops three X daily. 

The arithmetical multiplication sign, X> meaning " times," is often 
used in signatures, as above. 

The main rule in abbreviating should be to write an intelligible pre- 
scription. Grammatical correctness or elegance are subordinate con- 
siderations. An error in a prescription which merely annoys a Latin 

♦Thomas' Medical Dictionary. 



LANGUAGE. U^ 

scholar is absolutely insignificant when compared with an error which 
may lead to the dispensing of the wrong medicine. 

The first requisite in writing prescriptions should be to know the 
correct Latin official or ofiicinal titles and to use only them. If we 
could be sure that this was always done it would sometimes help us 
when in doubt about the reading. For instance: Hydr. chlor. could 
not then stand for chloral, because the official name is merely chloral. 
But when both words are used in Latin it would be chloral hydras 
(Br.) or chloral hydratum (G.), and the abbreviation would be chlor. 
hydr. , instead of hydr. chlor., the latter meaning mercuric or mercurous 
chloride. Of course, all these abbreviations would be wrong, but 
the point is that the sequence of such wrong abbreviations may occa- 
sionally enable us to decipher them in doubtful cases. 

Latin Phrases. 

Formerly the subscriptions of prescriptions were written out in 
Latin at great length, as in the following example copied from the 
United States Dispensatory, where it is to be found under the title 
11 Examples of Common Extemporaneous Prescriptions :" 

R— Olei ricini, f % iss. 

Tincturae opii, HI xxx. 

Pulveris acaciae, 
Sacchari, aa 3 ii. 

Aquae menthae viridis, f % iv. 

Acaciam et saccharum cum paululo aquae menthae tere; dein oleum ad jice, 
et iterum tere; denique aquam reliquam paulatim infunde, et omnia misce. 
S. : A tablespoonful to be taken every hour till it operates. 

The introduction of the use of such complicated subscriptions pos- 
sibly dates back to a time when physicians dispensed their own medi- 
cines, or, rather, had them dispensed by the young men who "read" 
medicine in their offices, and who were by no means competent phar* 
macists. Now, as a rule, druggists know better than physicians how 
to dispense a prescription, and such detailed directions in a subscrip- 
tion would be, to say the least, superfluous. They are, therefore, 
obsolete, except in England, where old habits seem to be adhered to 
with great pertinacity. The signatures are also written in Latin by 
some English authors, although by none others in the world, and to 
enable our readers to understand the most common of the phrases 
that they may meet with in English works, or in some English works 
"adapted to the United States Pharmacopoaia," we publish first a 
few examples of the signatures themselves, and then a list of the more 
common phrases. 

In this country it is the rule and custom to write very simple sub- 
scriptions and English signatures, and, therefore, the following lists 
are of comparatively little use here. 



1H HE PRESCRIPTION. 

Examples of Latin Signatures {Obsolete in the United States). 

Fiat mistura, aijus detur cochleare Let a mixture be made, of which 

magnum omni bihorio. a tablespoonful may be given 

every two hours. 
Fiat mistura. Hujus sumatur coch- Let a mixture be made. Of this 

leare medium omni tnhorio. sl dessertspoonful may be taken 

every three hours. 
Harum pilularum una sumatur Of these pills let one be taken 

omni nocte. every night. 

Hujus sumatur poculum omni tri- Of this let a cupful be taken every 

horio. three hours. 

Capiat cochleare minimum omni Let him (the patient) take a tea- 

hora. spoonful every hour. 

Examples of Words and Phrases {Obsolete in the United States). 

Latin. English. 

Absente febre fever being absent. 

Ad defectionem animi to fainting. 

Ad deliquium to fainting. 

Ad duas vices at twice taking. 

Ad libitum at pleasure. 

Ad pondus omnium to the weight of the whole. 

Admove apply. 

Adstante febre fever being present. 

Alternis horis every other hour. 

Alvo adstricta the bowels being constipated. 

Ana of each. 

Biduum space of two days. 

Bihorium during two hours. 

Bis in die twice a day. 

Bulliat let it boil. 

Capiat let him take. 

Cochleare magnum tablespoonful 

Cochleare medium dessertspoonful. 

Cochleare minimum teaspoonf ul. 

Cochleatim by spoonfuls. 

Cras mane to-morrow morning. 

Cras nocte to-morrow evening. 

Cnjus of which. 

Cujuslibet of which you please. 

Be die in diem from day to day. 

Beaurentur pilulce let the pills be gilded 

Bebitoe spissitudinis of a due consistence. 



LANGUAGE. 115 

Decanta decant ; pour off. 

Decubitu on going to bed . 

Digeratur let it be digested . 

Diluculo at daybreak. 

Dumfebris absit while fever is absent. 

Dumfebris adsit while fever is present. 

Durante febre during fever. 

Extende supra spread upon. 

Febre durante during fever. 

Gelatina quarts in any kind of jelly. 

; Guttatim drop by drop 

Guttis quibusdam with a few drops. 

JIarum pilularum sumantur tres let three of these pills be taken. 

Mora hour. 

Mora decubitus at bedtime. 

Mora somni at bedtime. 

Moroe unius spatuis in one hour. 

Moris alternis every other hour. 

In dies daily. 

In pulmento in gruel. 

Injiciatur enema let a clyster be given. 

Lateri dolenti to the affected side. 

Mane in the morning. 

Mane primo -in the early morning. 

Manipulus a handful. 

Mittatur sanguis let blood be drawn. 

More dictu as directed. 

More solitu ; . . in the usual manner. 

Nocte , at night. 

Node maneque at night and in the morning. 

Omni biduo every two days. 

Omni bihorio every two hours. 

Omni hora every hour. 

Omni mane every morning. 

Omni nocte every evening. 

Omni quadrante hora every quarter of an hour. 

Omnibus alternis lions every other hour. 

Partitis vicibus in divided doses. 

Peracta operatione emetici when the emetic has acted. 

Post cibo after eating. 

IPostsingulas sedes liquidas after every loose stool. 
Pro ratione in proportion to. 
p ro ratione aetatis according to age. 



116 THE PRESCRIPTION. 

Pugillus a handful. 

Quantum placet as much as you please. 

Quantum satis enough. 

Quantum sufficit as much as suffices. 

Quantum vis as much as you will. 

Quaqua hora each hour; hourly. 

Quaqua quarta hora every four hours. 

Quaterindie four times a day. 

Quorum of which. 

Quotidie daily. 

Secundum artem according to art. 

Secundum artis leges according to the rules of the art. 

Semihora half an hour. 

Sequenti luce the following day. 

Sesquihora an hour and a half. 

Si opus sit if there is occasion. 

Si vires permittant if the strength will permit. 

Statim immediately. 

Subinde now and then. 

Ter indie three times a day. 

Tere simul rub together. 

Vitello ovi solutus dissolved in yolk of egg. 

Some of these phrases are occasionally abbreviated almost beyond 
recognition, as seen in the examples we quoted above, but even when 
thus abbreviated our readers will have but little difficulty in recogniz- 
ing them . 



PAET IV. 



EXTEMPORANEOUS PRESCRIPTIONS. 

Preliminary Considerations. 

We have already learned that prescriptions are divided into two 
classes, permanent and extemporaneous , and have also learned that 
these differ not so much in their form, or in the character of the re- 
sulting preparations, but rather in the manner in which, and accord- 
ing to the circumstances under which, they are written. We desire 
to impress this fact clearly on the mind of the reader, especially as 
some writers have given entirely erroneous ideas on this subject. 

The permanent prescriptions are formulae which are kept perma- 
nently on record in books of reference, as, for instance, the pharmaco- 
pceial formulae for tinctures, wines, pills, etc. . The keeping quality of 
the products has nothing to do with the definition of a permanent pre- 
scription, although we have seen the definition that a permanent pre- 
scription is one which, when compounded, will yield a permanent 
preparation. So far is this from true that some of the most ephemeral 
of preparations — infusions — are made according to permanent pre- 
scriptions. 

On the other hand, an extemporaneous prescription, when com- 
pounded, may give products having great keeping qualities, as when 
we prescribe pills or mixtures of tinctures which will keep for an in- 
definite length of time. 

The word extemporaneous is from the Latin ex tempore— literally, 
out of the time— and means proceeding from the impulse of the mo- 
ment, unpremeditated, off-hand. This meaning sufficiently charac- 
terizes the nature of extemporaneous prescriptions. They are written 
by the physician to meet the peculiar requirements of an individual 
patient at the time of writing, and may, therefore, call for a combina- 
tion which would be inappropriate under any other circumstance or 
at any other time. These prescriptions are also called magistral pre- 
scriptions (from the Latin magister, master), because they are arbi- 
trarily or dogmatically written on the judgment of an individual 
whose authority in this matter admits of no dispute. Formerly the 
word magistral was also used as a synonym for sovereign or excel- 
lent, and a magistral remedy meant a sovereign remedy. 



118 THE PRESCRIPTION. 

The term prescription is often understood by the public to mean * 
the piece of paper given them by the physician, with all that is written 
thereon. In this sense we will now consider it. 

Prescription Blanks. 

It is customary for the physician to carry with him prescription 
blanks, with the address of some pharmacist printed on the back of ? 
them. When the physician uses these blanks it is generally under- 
stood by the public to mean that they must go to the drug store des- k 
ignated on the back to get their medicines. The physician should, I 
therefore, use the blanks of such druggists only as he believes to be I 
thoroughly competent. It is not necessary again to dwell on this 1 
matter, as the views of the writer are fully set forth in the earlier j 
part of these pages under the head, " Specifying in Prescriptions." * 9 

Many physicians prefer to use their own blanks without any drug- 1 
gist's address on them, and this is preferable when the physician I 
makes visits at long distances from his home. He can then designate 
verbally to which drug store in the neighborhood of the patient's 
home the prescription is to be taken for compounding. 

Writing. 

But whether the physician uses his own or some pharmacist's blank, 
this piece of paper should be sized so as to be fit for pen-and-ink 
writing. To rely on any chance supply at the house of the patient, 
odd bits of wrapping paper, the inside of old envelopes, leaves torn 
from memorandum books, etc., denotes slovenliness and carelessness 
on the part of the prescription writer, and the public is lead to think 
that he writes so few prescriptions that he doesn't find it worth while 
to carry paper with him. It is one of the many minute influences in 
regard to which attention or neglect contributes in some subtle man- 
ner to success or failure in practice. These blanks should, there- 
fore, be of good paper, well and smoothly kept in a pocket-book, or in 
blocks, and especially should they be kept clean. The writing on 
them should be as plain as can be, not in lead-pencil, but in ink, 
which is quite feasible in these days of fountain pens. Lead-pencil 
marks often become blurred and almost illegible by the handling 
they receive before they are presented for compounding. The poor 
penmanship of some physicians only too clearly betrays their want 
of general education, and is another of those small influences which, 
perhaps, amount to little in themselves, yet exert such great influ- 
ence in the aggregate in making or marring one's career. To affect 

*See page 30. 



EXTEMPORANEOUS PRESCRIPTIONS. 



11!) 



an eccentric, peculiar, and illegible chirography, under the mistaken 
idea that a poor handwriting will be considered an evidence of genius, 
is a form of quackery unworthy of the educated physician. When the 

writing is in ink, the paper should not 
be folded until it is perfectly dry, to 
avoid blurring and consequent possi- 
ble mistakes. 

The dissecting-room joke of draw- 
ing a skeleton is probably familiar to 
all; by folding a piece of paper so as 
to form a crease, then writing along 
one side of the crease the word "cent" 
with a long stroke through the "t," 
and folding again so as to produce a re- 
versed impression on the opposite side 
of the crease, the crude figure of a 
skeleton may be produced. A similar 
effect in a prescription may transform 
3- into g, or IV, V, VI, VII, or VIII 
into IX, X, XI, XII, or XIII, or it may 
so blur the entire prescription as to 
make it utterly illegible. 
When the waiting is dry, the paper is ready to be delivered to the 
patient. If the physician can conveniently do so, he may put the pre- 
scription into an envelope before giving it to the patient. This pre- 
vents the soiling and tearing of the prescription, and, by keeping it 
clean and legible, acts to some extent as a safeguard against mis- 
takes. 

Besides the prescription proper, or the directions for compounding 
the medicines, a number of other things are written on the blank. 




The Date. 



The first thing should be the date. This is usually written at the 
head of the blank. The best method is to write the name of the 
month, either in full or abbreviated, then the number of the day, and 
then the year, thus : Sept. 27, '86. The number for the year is gener- 
ally abbreviated by omitting the number of the century, simply writ- 
ing 86, preceded by an apostrophe, as in the above line. Some prefer 
to w^rite the number of the month instead of writing the name. This 
often gives rise to confusion if Arabic numerals are used, because 
there is no uniform rule as to whether the number of the month or 
the number of the day shall be written first. Some would write the 
sixth day of September, 6. 9. '86; some would write it 9.6. '86; others 



120 THE PRESCRIPTION. 

write it in the style of a fraction, 6/9. >86, or 9/6.'86. When the num- 
ber of the day is 13 or more, of course no mistake can occur, but in 
the illustrations given above no one could positively say whether the 
ninth day of the sixth month or the sixth clay of the ninth month was 
meant by the writer, unless he was acquainted with the physician's 
habit in this regard. 

We should, therefore, always write the number of the month in 
Roman numerals, and the number of the day in Arabic numerals, 
when it will, of course, make no difference which is written first, for 
6. ix.' 86 or ix. 6.' 86 will be equally intelligible. 

Name of the Patient. 

Then there should follow on the blank a line for the name of the 
patient, thus: 

For 

The prescriber should not neglect to insert the name of the person 
for whom the medicine is intended, because it is a safeguard against 
mistake. The druggist is less liable to deliver the medicine to the 
wrong party, and at the home of the patient there is less likelihood of 
the administration of the medicine to the wrong member of the house- 
hold. 

Cka::ity Patients. 

If the patient is poor and unable to pay full price for his medicines, 
the physician may write the letter "P" on the prescription after the 
name, which means the patient is poor (the letter stands for the Latin 
word pauper, poor) . If the patient is unable to pay anything at all, 
the letters U PP" (pmiperrimus, very poor) will convey the informa- 
tion to the druggist. Of course, the physician ought not to use these 
signs unless he himself is also serving in the case gratuitously, as it 
would be unfair for him to collect his fees and then send the patient 
to become a tax on the charity of the pharmacist ; nor should unnec- 
essarily expensive medicines be ordered for charity patients. 

Prescriptions for Emergency Cases. 

In an emergency case it may be necessary to have the medicine dis- 
pensed in a hurry, and this may be indicated in the prescription by the 
words cito (quick), or citissime (very quick, or quickest), and the pre- 
scription will have precedence over everything else, but the prescrip- 
tion should be as simple as possible, so as to be easily and quickly put 



EXTEMPORANEOUS PRESCRIPTIONS. 121 

up. Prescriptions for infusions, decoctions, and other time-consum- 
ing preparations would be out of place. So, also, would prescriptions 
for pills, capsules, and other slow-acting forms of remedies be inap- 
propriate for emergency cases, in which fluid preparations will be 
found to act most promptly. 

The above words, if used at all, are written at the head of the pre- 
scription blank so as to attract attention at once. 

Physician's Address. 

Then follows the prescription proper, which we will consider here- 
after, and after it should come the full name of the physician— if pos- 
sible, in plain print— together with his full address and his office 
hours, which latter may be of importance in case the physician should 
make an error in his prescription, which would require the pharma- 
cist to consult him before putting up the medicine. 

About Repetitions. 

Some physicians have recently commenced the practice of writing 
immediately after the signatura of the prescription the words, " not to 
be repeated." It is doubtful whether this direction can be obeyed by 
the pharmacist, and it is probably superfluous. and useless. When 
this direction is on the blank, the patient will generally demand that 
his prescription shall he returned to him, and no druggist would hesi- 
tate to put it up without asking whether it had been previously com- 
pounded or not, and many pharmacists will pay no attention to any 
such directions. The question of ownership in the prescription is a 
very vexing one, and while the writer inclines to the belief that the 
prescription belongs to the patient who has paid for it, there are 
others who claim it to be the property of the physician, and some 
who believe it to become the property of the pharmacist who com- 
pounds it. The question is not likely ever to be satisfactorily settled, 
and, therefore, it is not necessary to say more about it than that it 
will be of little or no use to write " not to be repeated." 

The Prescription. 

From time immemorial it has been considered to be the aim of the 
physician to cure rapidly, safely, and pleasantly {curare cito, tuto, etju- 
cunde), and the modern prescription is written with these aims in 
view. To accomplish these objects, a complete compound prescrip- 



■ inscription. 



122 THE PRESCRIPTION. 

tion contains several parts which have received various names from 
different writers. All writers agree in adopting this scheme: 

Superscript™ superscription. 

Inscriptio 

seu 
Designatio materioe 

seu 
Prcvscriptum proprium 

seu 

Prcescriptio propria , 

Subscripts subscription. 

Signatura signature. 

The superscription (superscript™, onis> f., from the Latin super, 
above, and scriptio, onis, f., writing), at the present time consists, in 
a Latin prescription, of the letter R or the sign $.. In an English 
prescription it is customary to write " take of," while the French 
usually write P. (abbreviation for prenez, take), and the Germans be- 
gin with " Man nehme," or " nimm " (take) . 

The letter R in the Latin prescription is an abbreviation from 
recipe (imperative of the verb recipio, 3, to take), and means "take." 
The sign I£, however, has a different origin. In ancient times it was 
customary to invoke the blessing of the deity on the remedies to be 
taken by a formal prayer at the beginning of the prescription, and, 
with the usual attempt of the physicians to abbreviate as much as 
possible, these invocations finally dwindled down to merely naming 
the deity addressed, and, later, to write, instead of the names, the signs 
used to desiguate them. Thus the aid of Mercury, the god of mer- 
chants and thieves, was invoked by using the sign § as a superscrip- 
tion; the aid of Venus, goddess of love, beauty, and pleasure, by 
using the sign 9 (rude representation of a hand-mirror) ; or the aid of 
Jupiter, the supreme god and father of gods, by using the symbol %, 
now also used as a zodiacal sign for the planet Jupiter. This sign 
survives in the shape of $., especially as generally written, being 
merely furnished with the stroke of the R. In the oldest pharmaco- 
poeia known, the Egyptian papyrus from Thebes, already previously 
referred to, no invocation or superscription was used, but the physi- 
cian began abruptly with an enumeration of the ingredients of his 
prescription. The use of these invocations was of a later date and 
originated among the Greeks and Romans, and continued to the time 
of the alchemists. At that time the influence of the Church on the 
minds of men, or perhaps the fear of the Inquisition, led physicians 
to adopt an invocation to the Christian God, and, just as they abbre- 
viated a prayer to crossing themselves with their fingers over their 
foreheads and breasts, so they contracted the invocation to the sign 



EXTEMPORANEOUS PRESCRIPTIONS. 123 

of the cross, ►{«, as a superscription. Sometimes a double cross, ± 
was used, aud the writer knew a physician who used this double 
cross at the head of his prescription blank but a few years ago. 

Some used the abbrevation A Q (the Greek letters Alpha and Ome- 
ga), which referred to God as the beginning and end of all things; 
or the letters J. D. (Juvante Deo, God helping), or J. J. (Juvante Jesu, 
Jesus helping). 

Others used the words Cum Deo (with God, or in the name of God), 
or abbreviated these words to C. D.; or the letters JST. D. (Xomine 
Deo, in the name of God), thus beginning their prescription with the 
formula even now used by many ministers in opening services on Sun- 
day when they say, "In the name of God, Amen!" ("/*» JSTamen cles 
Herrn, Amen! Lasset uns singen," etc.) 

In view of this origin of the use of a superscription, it becomes a 
question of interest whether u Superscript™" should not have been 
" Superstition The only trace of all this superstition to be found in 
the modern prescription is the little appendix to the letter R, as seen 
in the sign g.. 

The inscription (inscription onis, f ., from the Latin verb inscribo, 3, 
to write down, to describe, to designate) consists of an enumeration 
of the medicinal substances which are to be used in compounding the 
prescription. Either of two plans may be followed in writing this 
part of the prescription — to enumerate the medicines in a definite or- 
der according to their therapeutical importance, or to write them in 
the order in which the pharmacist takes them for compounding. 

The first is the more common plan, because it is the easier. Writ- 
ers are not all agreed on the best form of this plan, some subdividing 
the remedies into four, others into five groups. In either case, how- 
ever, the plan is based on the direction to cure quickly, safely, and 
pleasantly (curare cito, tuto, et jucunde) . In fact, the division into four 
groups, according to therapeutical importance, seems to have been 
adopted, not so much on account of the relative value of the ingre- 
dients as from a desire to adapt the modern prescription more closely 
to the above classic advice of Asclepiades. We see this in the follow- 
ing plan: 

base curare, 

auxiliary. . . ..cito, 
corrective .... tuto, 

vehicle et jucunde. 

The base (basis, is, f .) is the most important ingredient of the pre- 
scription, on which the main reliance for cure is based. No one 
remedy, however, always answers all the indications of the case and it 
may be necessary to add some other ingredient to increase the medic- 
inal effect of the base. This is called an adjuvant or auxiliary (ad~ 



The inscription consists of 



124 THE PRESCRIPTION. 

juvans, antis, n., from the verb adjuvo, 1, I assist), and is intended to 
comply with the command to cure quickly. 

If either the base or adjuvant has objectionable therapeutical prop- 
erties, a third ingredient, the corrective (corrigens, entis, n., from the 
verb corrigo, 3, I improve) is added, which complies with the demand 
to cure safely. Lastly comes the vehicle (vehiculum, i, n., also for- 
merly called constituens) , in which the other ingredients are dissolved 
and conveyed to the patient, and which usually consists of flavoring 
tinctures, syrups, simple elixir, sugar, water, etc. It fulfills the com- 
mand to cure pleasantly . 

Another, slightly different and preferable, method of subdividing 

the inscription is as follows : 

f base curare, 

I adjuvant... cito, 

The inscription consists of *j corrective, .tuto, 

excipient, ) ^ . 

_., ■ > et mcunde. 

diluent, ^ 

The base, adjuvant, and corrective are as above, but, instead of a 
vehicle, there are two divisions: the excipient (excipiens, entis, n.), 
which is added for the purpose of correcting objectionable organolep- 
tic properties (taste and smell), or to give a desirable consistence, as 
when a syrup or mucilage is added to a mixture to prevent a sus- 
pended powder from subsiding too rapidly; and a diluent (dihtens, 
entis, n.), consisting of some medicinally inert substance, which is 
nsed to dilute the more active ingredients, either because it is physic- 
ally impossible otherwise to divide the medicines into proper doses, 
or because it is undesirable to give the remedies in a concentrated 
form, or because the addition of the diluent allows us to adjust the 
doses for the use of one of the ordinary household approximate meas- 
ures, as the teaspoon or tablespoon. The corrective is also some- 
times called a directive, as will be explained further on; and in pre- 
scriptions for troches, pills, suppositories, etc., a conspergative (con- 
spergens y entis, n., from the verb conspergo, 3, to strew or sprinkle) 
is not infrequently employed. We may have, therefore, the following 
ingredients in a prescription: base, adjuvant or auxiliary, corrective 
or directive, excipient, diluent, and conspergative, following each 
other in the order named. 

Instead of following each other in the above order, these different 
parts of the prescription may be written in the order in which they 
are added to each other in compounding; but as this must vary ac- 
cording to the nature of the medicine to be dispensed, it requires a 
knowledge of pharmacy to write a prescription in this manner, and no 
rule can be given, but the method can only be illustrated by an exam- 
ple. The following prescription, from the "Companion to the United 



EXTEMPORANEOUS PRESCRIPTIONS. 125 

States Pharmacopoeia," illustrates this method sufficiently well, the 
parts being designated on the right in parentheses: 

R— Amygdalae olei dulcis, f 3 vi (adjuvant). 

Acaciae pulveris, (excipient), 

Aquae, ana quantum satis (diluent) 

ut tiant emulsionis iX iii. 
Adde 

Opii tincturae, f 3 i (base). 

Bismuthi subcarbonatis, 3 i (adjuvant). 

Saccbari syrupi, f§ i (excipient). 

Misce. Signa: 

When the prescriber is familiar with the manner of compounding, 
this method of prescribing is very convenient, and preferable to the 
mere enumeration of the different parts of the prescription in a cer- 
tain fixed sequence, but the latter plan is better when the physician is 
not familiar with pharmaceutical manipulations. 

The next part of the prescription is the subscription {subscription 
onis, f., from sub, under, and scriptio, writing), which is the direction 
to the pharmacist how to compound. This was formerly quite com- 
plicated, but is now exceedingly simple, often being contracted to the 
letter M only (misce, mix). The subscription needs no further men- 
tion now, but will be considered again further on. 

Then follows the signature (signature: , ce, f ., the mark), which is the 
direction to the patient how to use the medicine, which is to be marked 
on the label by the dispenser. This should always be in the plain ver- 
nacular language, and should be put on the label with the same care 
and completeness as the different ingredients are put into the medi- 
cine to be dispensed. When the physician gives complete directions 
in the signature, and the druggist substitutes for them on the label 
the words, "to be used as directed," he is morally as responsible for 
an error or accident occurring in consequence as if he had substituted 
morphine for quinine. 

This concludes the prescription proper, after which, as already 
stated, should follow the full name and address of the physician, 
when the whole prescription is done. 

We will now consider the parts of the inscription somewhat more 
fully. 

The Base. 

When the physician has made his diagnosis, he determines what 
remedy will meet most of the indications of the case, and writes it 
down after the g.. This remedy being the most important, is to cure 
(curare), and is the base of the prescription. It is often the only in- 
gredient, as when we prescribe tincture of muriate of iron, or solution 
of citrate of magnesium, or any single preparation, as in the following 
examples : 



12G THE PRESCRIPTION. 

R— Tincturae ferri chloridi, f 5 i. 
Signa: 20 drops three X daily. 
Or: 

R— Pilulas ferri iodidi, XXIV. 
Signa: 1 pill morning and evening. 

When the base is sufficient to meet all the requirements of the case 
therapeutically, and is in such a shape that it can be administered 
without the addition of any other substance, it is, of course, unneces- 
sary to add anything further. Paris, in his " Pharmacologia," says on 
this subject: 

"Let it be distinctly and unequivocally understood that, unless a 
physician can satisfactorily explain the operation of each element in 
his prescription, * * * simplicity should ever be regarded as the 
greatest desideratum ; * * * he may be assured that, unless he 
be well acquainted with the mutual actions which bodies exert upon 
each other and upon the living system, it may be laid down as an 
axiom that, in proportion as he complicates a medicine, he does but mul- 
tiply the chances of its failure. Let him cherish this maxim ia his re- 
membrance, and in forming compounds always discard from them 
every element which has not its mode of action clearly denned, un- 
less, indeed, a general and paramount experience shall have stamped 
upon it the authentic seal of approval. 

"There is this marked distinction between the raw and well-disci- 
plined practitioner, that while the one, seeing only a variety of uncon- 
nected symptoms, seeks to attack each by a separate ingredient in his 
prescription, the other, by being enabled to group together such as 
arise from a single cause, diminishes in number and variety the points 
to be attacked, and simplifies his remedies in the same ratio. 

"The perfection of a medicinal prescription may be defined by three 
words. It should be precise (in its directions), concise (in its con- 
struction), decisive (in its plan of operation).- It should carry upon 
its very face an air of energy and decision, and speak intelligibly the 
indications which it is intended to fulfill. It may be laid down as a 
maxim, which is not in much danger of being controverted, that 
where the intention of a medicinal combination is obscure, its operation 
will be imbecile." 

Adjuvant. 

Bearing in mind, then, the undesirability of adding unnecessarily to 
uiie base, there may yet be occasions when w T e can improve its action 
toy the addition of another drug and thus accelerate the cure, as when 
■We add senna to epsom salts in the popular " senna and salts." This 
second ingredient is to cure quickly (cito), and is called the adjuvant 
(which means assistant) . 



EXTEMPORANEOUS PRESCRIPTIONS. 127 

Examples of adjuvants in prescriptions are quite common. Cathar- 
tics are often given in combination, assisting each other in action. It 
is very common to combine tonics, as when vegetable bitters are 
combined with iron ; and vegetable alteratives are commonly added to 
the mercurials for specific diseases. 

If we combine two or more substances essentially similar in ac- 
tion — as, for instance, two cathartics, diuretics, etc. — the combina- 
tion will act more promptly and effectually than either one of the 
drugs alone. In such combinations the dose of each drug is propor- 
tionately less than if it were given without the other. 

In the following prescription we combine the tonic effects of qui- 
nine and iron, thus : 

R— Quininse sulphatis, gr. xx. 

Acidi citrici, q. s. 

Ferri et ammonii citratis, 3 i. 

Sacchari syrupi, f 5 i. 

Aquae purse, f5 v. 
Misce. Fiat solutio. Signa: 



Quinine may be considered as the base, iron as the adjuvant, citric 

acid as an excipient to dissolve, and syrup to improve the taste; 

while, lastly, water is a diluent for ease of administration and simple 

solution. 

R— Opii pulveris, gr. iv. 

Hyoscyami extracti, 
Conii extracti, aa, gr. xii. 

Misce et divide in pilulas XII. 
Signa: 1 pill at bedtime. 

In this prescription several narcotics are combined, and in this 
form will frequently act better than when one alone is given. Opium, 
of course, is the base, and the other ingredients are adjuvants. As 
these are soft, no special excipient is needed in this case to make a 
pill mass. 

An adjuvant need not necessarily be a drug having a therapeutical 
effect similar to the base, but may belong to quite a different class of 
the materia medica, provided, of course, that the actions of the base 
and adjuvant will not interfere. 

A diuretic with a diaphoretic would not be a suitable combination, 
because the two excretions antagonize, or at least complement each 
other; diuresis being diminished when diaphoresis is increased, and 
vice versa. 

A powerful adjuvant in all cases, though not expressed in the pre- 
scription, is the diet we prescribe for our patients. It would be ab- 
surd to give "slop diet" with tonics, or beef tea and milk punch with 
antiphlogistics. 

Occasionally in febrile cases the pulse is full and hard, and the 
pressure within the vessels such that absorption can not take place 



128 THE PRESCRIPTION. 

readily. In such cases we may combine with our remedies a small i 
quantity of some sedative or depressing agent, which will relax the ' 
system and, therefore, favor absorption. In the following prescrip- 1 
tion we have added for this purpose a small quantity of tartar emetic: J 

R— Magnesii sulphatis, 3 i. 

Potassii et antimonii tartratis, gr. i. 

Syrupi acidi citrici, f S i. 

Aquas purse, q. s. ut fiant solutionis f§ iv. 

Misce. Signa: 

Tartar emetic, or veratrum viride, may frequently be added to ca- 
thartics, diaphoretics, and, in fact, to all eccritics or eliminatives. 

Either of these remedies might also be given separately, as when we 
give tartar emetic to produce vomiting before administering qui- 
nine, for instance. The act of vomiting relaxes the system and the 
remedy will be absorbed more readily, so that in effect, if not in name, 
the tartar emetic would be an adjuvant to the quinine. Some of our 
" old-fashioned " practitioners are in the habit of commencing all 
their treatments with an emetic (or with a cathartic, which acts simi- 
larly, though weaker) . It is probable that this treatment is a little 
too much neglected and undervalued at present, and that emetics de- 
serve more frequent employment; of course, it must not be a mere 
matter of routine to give them, but they must be indicated. 

The following familiar formulae for pills show the use of adjuvants: 

Antibilious Pills (Vegetable). 

Extr. colocynth. comp., 2V2grs. 
Resin, podophyll., V4gr. (adjuvant). 

Dose: 1 to 4 pills 

Alterative Pills. 

Extr. colocynth. comp., U/2 grs. 
Pulv. rhei, 11/2 grs. (adjuvant). 

Pil. hydrarg., 1 gr. (adjuvant). 

Ol. carui, 1/40 drop. 

Dose: 1 to 3 pills. 

In the following " shot-gun prescription" it would be difficult to say 
which ingredient is the base, unless we simply assume the first men- 
tioned to be such, although all are of about equal value. 

Neuralgic Pills (Brown- Sequar&s). 

Extr. hyoscyami, 2/3 gr, 

Extr. conii, 2/3 gr. 

Extr. ignat. amar., 1/2 gr. 
Extr. opii, 1/2 gr. 

Extr. aconiti fol. , 1/3 gr. 
Extr. cannab. Indie, 1/4 gr. 
Extr . stramon . , 1/5 gr . 

Extr. belladonn. fol., 1/6 gr. 
Dose: 1 pill. 



EXTEMPORANEOUS PRESCRIPTIONS. 129 

This might properly be said to be "all adjuvants." Experience oc- 
casionally teaches the value of such combinations, but as a rule we do 
better to avoid them. 

Corrective, or Directive. 

Occasionally either one or both of the above-described ingredients 
of a prescription possess some disagreeable physiological or thera- 
peutical effects, such as irritating, pungent taste, or a tendency to 
cause griping or nausea, etc., and we find it necessary to add a third 
ingredient to overcome such objectionable features. This ingredient 
is to cure safely (tuto), and is called the corrective. Sometimes it is 
also called directive; for instance, when turpentine is given in a ta- 
blespoonful dose to expel lumbrici, it occasionally fails to act on the 
bowels, but acts on the kidneys, in which unfortunate event it may 
produce serious injury, such as strangury, or even hematuria. We 
can correct this tendency to act on the kidneys by directing the action 
of the turpentine to the bowels by adding castor oil. Spigelia may be 
given for the same object as turpentine, and usually purges; if it 
fails to purge, it will act as a narcotic poison. We can correct the 
tendencv to act as a poison by directing its action to the bowels by 
adding senna, whence the popular "pink root and senna" combina- 
tion. 

Some authorities have erroneously said that the adjuvant is some- 
times called a directive, but a careful analysis of the action of this 
ingredient will show that in almost all cases in which a directive 
action is obtained it is for the purpose of correcting a tendency to 
produce undesirable effects, and, therefore, that a directive is always 
a corrective, although a corrective is by no means always a directive. 

The corrective is less frequently employed than any of the other 
ingredients of the prescription, although when indicated it is quite an 
important part of the prescription. 

R— Cantharidis tincturae, f 3 i- 

Amygdalae misturae, f 5 iii- 
M. S. : Dessertspoonful four times daily. 

In this prescription for chronic gleet the irritant properties of the 
cantharides are completely disguised by the demulcent almond emul- 
sion, which acts both as corrective and as a diluent. 

R— Hydrargyri chloridi mitis, gr. yiii. 
Opii pulveris, g r - *• 

Sacchari pulveris, 3 ss. 

Misce et divide in pulveres VIII. 
Such a combination of opium with calomel is frequently employed 
when the mercurial is given in syphilis, and we desire 10 correct its 



130 THE PRESCRIPTION. 

tendency to purge, or to direct its action so as to produce constitu. 
tional effects. 

Compound Cathartic Pills (Improved). 

Extr. colocynth. comp., IV2 grs. 

Extr. jalap., 1/8 gr. 

Resin, podophyll., 1/8 gr. 

Resin, leptandrae, 3/8 gr. 

Extr. hyoscyami, 1/4 gr. {corrective). 

Extr. gentianaB, 1/2 gr. 

Ol. menth. pip., 1/40 drop. 
Dose: 1 to 3 pills. 

Mandrake Pills (Dr. E. B. Squibbs'). 

Resin . podophyll . , 1/4 gr . 
Extr. belladonn. fol., 1/8 gr. (corrective). 
Capsici pnlv. , 1/2 gr. 

Dose: 1 or 2 pills. 

Calomel and Bhubarb Pills. 

Hydrarg. chlorid. mit., 1/2 gr. 
Extr. rhei, 1/2 gr. 

Extr. colocynth. comp., 1/2 gr. 
Extr. hyoscyami, V6gr. (corrective). 

Dose: 1 to 3 pills. 

Aloes and Iron Pills. 

Pulv. aloes socotr., 1/2 gr. 
Extr. conii, V2gr. (corrective). 

Ferri sulph. exsicc. , 1 gr. 
Pulv. zingib. Jamaic,, 1 gr. 
Dose: 1 to 3 pills. 

Aloes and Myrrh Pills (U. S. P.). 

Pnlv. aloes socotr., 2 grs. 
Pulv. myrrh., 1 gr. 

* Pulv. aromat., V2gr. (corrective). 

Dose: 3 to 6 pills. 

Probably the best known examples of prescriptions containing 
a corrective can be seen in the many popular formulae for laxative 
pills, in which extracts of belladonna, hyoscyamus, orconium are used 
to correct tfte tendency of the cathartic ingredients to produce grip- 
ing. These extracts are preferred to opium and similar narcotics, be- 
cause they do not produce constipation, but rather promote the ver- 
micular action of the intestines. 

Excipiext. 

The next ingredient in the prescription is the excipient, to cure 
pleasantly (jucunde). This may be added for the purpose of giving a 
certain consistence to the medicine, as when we add syrup or muci- 
lage to a mixture to prevent a too rapid subsidence of the insoluble 



EXTEMPORANEOUS PRESCRIPTIONS. 131 

particles; or when we add acacia to emulsify an oil; or an adhesive 
substance to powders to make a pill mass. The excipient is also 
added for the purpose of rendering the preparation pleasant to the 
patient, as when we add aromatics, syrups, etc., to disguise the un- 
pleasant taste of many of our remedies, or for improving the smell or 
appearance. 

Much of the success of homoeopathy has been due to the pleasant- 
ness of its remedies, and a careful attention to rendering the medicines 
as palatable and elegant as possible will add much to the physician's 
popularity. He should, therefore, pay due regard to making his medi- 
cines pleasant in taste, smell, and appearance. 

An excipient may be added for mechanical purposes, as when we 
write: 

R— Quininae sulphatis, 2- Gm. 
Opli pulveris, o- 1*2 Gin. 

Gentians extract! , q. s. 

Misee <-t divide; in pilnlas XVI. 

Consperge pnlvere cinnaniomi. 

In this prescription the extract of gentian is an excipient to produce 
ertain consistency ; it enables us to make a mass with the other dry 
ingredients. Some authors say that in such prescriptions the choice 
of excipient may be left to the pharmacist, but an intelligent pre- 
server will not leave anything to the choice of another, but will make 
his prescription perfect and complete by naming every ingredient, ex- 
cipient not excepted. It is, however, impossible always to state the 
exact amount of excipient required to make a mass, and the deter- 
mination of the exact quantity may properly be left to the discretion 
of the dispenser, provided that the pharmaceutical requirements are 
such as to permit this without affecting the therapeutical characteris- 
tics of the finished product. When the determination of the quantity 
is left to the pharmacist, this is indicated by omitting mention of a 
quantity after the ingredient, and writing, instead, the abbreviation 
v?. s. {quantum satis; name of ingredient in the genitive case). But 
q. s. must never be written when the pharmaceutical requirements do 
not hx the amount to be used. It would be wrong to use it, for in- 
stance, as follows: 

R— Quininae sulphatis, 3 i- 
Yerlue santie syrupi, q. s. 
Misce et sigua: Tablespoonful every two hours. 

If the druggist took 1 fluidounce, the close of quinine would be 30 
grains; and if he took G riuidounces, the dose would be only 5 grains; 
and there is nothing in the prescription to assist him in determining 
the amount. 

An excipient is also used for a mechanical purpose when we order 
a dry and insoluble powder to be dispensed, suspended in a liquid. 



132 THE PRESCRIPTION. 

We then add syrup or mucilage to render the liquid viscid, so that the 
powder will subside but slowly, as in the following: 

R— Bismuth i subcarbonatis, 3 ii. 
Cretae mistura3,__ 
Acacias syrupi, aa, fgiss. 

Misce. 

Such a preparation is often called a " shake mixture," and a label 
with the direction, " to be well shaken," may be pasted on the vial, 
just above or below the regular label. 

Instead of using syrup or mucilage, we may order powdered gum 
arabic, which is mixed with the other powders, and then the water or 
other diluent is slowly added during constant stirring. 

The disagreeable taste of many preparations may be greatly im- 
proved by the choice of a proper excipient; but taste should not be 
rendered more agreeable at the expense of efficiency, unless the patient 
absolutely refuses to take the more disagreeable and active prepara- 
tion. 

The bitter preparations can not be greatly improved by syrups, for 
the sweetish-bitter taste becomes nauseous to many. Aromatics will 
usually be better for the purpose. 

Alkaline, sour, or salty preparations may be sweetened with syrups. 
Acrid and pungent substances may be dispensed in mucilages and 
syrups. Nauseous drugs are rendered more agreeable by the addition 
of volatile oils, bitters, or aromatics, while insipid medicines may be 
flavored with aromatic, sweet, sour, or bitter excipients. 

Modern elegant pharmacy has enriched our materia medica with 
mauy very palatable preparations, such as wine of beef and iron, 
elixirs of various kinds, syrups, wines, malt preparations, and numer- 
ous other combinations in which pleasant flavor, taste, and appear- 
ance are united with effectiveness and ready assimilability. Great 
differences exist in these regards, however, between the preparations 
of the same name made by different makers, and the physician will do 
well to use judicious discretion in choosing between them. Many of 
the preparations of this kind, such as compound elixir of taraxacum, 
aromatic elixir, elixir of licorice, syrup of yerba santa, etc., are very 
good excipients to be added to extemporaneous prescriptions; those 
mentioned here disguising almost completely the disagreeable taste 
of even as bitter a remedy as quinine. 

If quinine is dispensed in a mixture with aromatic syrup of rhubarb, 
chocolate, licorice, compound elixir of taraxacum, or elixir of wild 
cherry bark, or with any other excipient, to disguise its taste, no acid 
must be added, as these substances will not be able in that case to 
overcome the intense bitterness of the drug. 

While attention is paid to taste and flavor, the appearance must not 



EXTEMPORANEOUS PRESCRIPTIONS. 133 

be neglected. Frequently some coloring substance— for instance, 
compound tincture of lavender, or compound tincture of cardamom- 
will give an attractive appearance, where otherwise this might not be 
so. A patient is usually a very fastidious person, and will take a pleas- 
ant remedy much more willingly than one that is repulsive both to the 
eye and to the taste. 

The conspergative in prescriptions for pills is really a form of ex- 
cipient, specified in the prescription in order that the pills may have 
the same flavor and taste, wherever and by whomsoever they may be 
compounded. Strictly speaking, a gelatin or sugar coating is also an 
excipient. 

The Diluent. 

The last ingredient in a complete prescription is the diluent, which 
has no therapeutical value, and is added merely for mechanical rea- 
sons. It is added, as the name implies, to dilute the more active 
ingredients, and maybe either solid or liquid. It is most useful in 
adjusting doses, making up the desired quantity, or when the dose of 
the remedy is so small that it can not by itself be weighed out into 
doses at all, as when we try to divide 1 grain of strychnine into 100 
doses. Here, of course, we must add some other ingredient to make 
the whole bulky enough to allow of division. 

R— Morphinae sulphatis, gr. i. 

Sacchari albi, 3 as (diluent). 
Misce et divide in pulveres VIII . Signa : 



R— Morphinae sulphatis, gr. i. 

Glycyrrhizae pulveriS; gr. viii (diluent). 

Gentlanae extract! , q. s. 
Misce et divide in pilulas VIII. Signa: 

R— Morphinae sulphatis, gr. i. 

Aquae rnentlue piperitae, f§ i (diluent). 

Fiat solutio. Signa: 

In the above three examples we see the use of both liquid and solid 
diluents, added for the purpose of enabling us to divide 1 grain of 
morphine into doses of } 8 grain each. One powder, 1 pill, or 1 tea- 
spoonful of the solution, each, contain that dose. 

The same ingredient often answers both as excipient and diluent, as 
when we dissolve various chemicals in simple or aromatic elixir, as 
in the following example : 

R—Quininae sulphatis, Z i- 

Elixiris taraxaci cornpositi, f5 iv. 
Misce et signa: Tablespoonful every four hours. 

Here the compound elixir of taraxacum answers the double purpose 
of diluting for ease of administering the doses and as an excipient to 



134 THE PRESCRIPTION. 

disguise the bitter taste of the quinine, and it will be found more con- 
venient to use the term " vehicle " in a case of this kind. 

The determination of the amount of diluent to be added depends 
upon the number and size of the doses we wish to give. If we deter- 
mine, for instance, to give twelve doses of 30 grains each of bromide 
of potassium every two hours, in elixir of orange peel, we will at 
once see that a teaspoonf ul dose will not answer our purpose, because 
the salt can scarcely be dissolved in this small quantity of fluid, and, 
if it could, it would be too concentrated a solution to taste well. A 
dessertspoonful — or, still better, a tabiespoonful — dose will be more 
pleasant, and we therefore add enough of the vehicle to the 6 drams 
of the bromide to make 12 tablespoonfuls or 6 fluidounces, as fol- 
lows : 

R— Potassii bromidi, 5 vi. 

Elixiris aurantii corticis, f § vi. 
Fiat solutio. Signa: Tabiespoonful every two hours. 

This is really a little more than 6 fluidounces, as the dissolved salt 
occupies some little space ; but when the quantity of the salt or other 
dissolved material is small, we ignore this little inaccuracy, and men- 
tion a definite quantity of diluent or vehicle. But when the total bulk 
of a number of salts, tinctures, and other ingredients is appreciable in 
quantity, but not readily ascertained, or when, to make an even total 
volume, the quantity of diluent would have to be expressed in frac- 
tions of drams or ounces other than halves, it is preferable not to 
state the quantity of diluent or vehicle in the prescription, but to write 
"q. s." after it, as in the following example: 

R— Magnesii sulphatis, 5 i. 

Podophylli extracti fluidi, f 3 ii. 

Rhei syrupi, f 5 ss. 

Aquae q. s. ut ft. sol. f 5 iv. 

M. S.: 

The more usual form of expressing this is shown in the next form 
of the same prescription : 

R— Magnesii sulphatis, § i. 

Podophylli extracti fluidi, f3 ii. 

Rhei syrupi, f § ss. 

Aquam ad f 5 iv. 

M. S.: 

The word " ad " means that enough of the ingredient be taken " up 
to" or "to make" the quantity which follows the word "ad." In 
the above example the epsom salt, fluid extract of mandrake, and 
syrup of rhubarb are to be placed in the vial, and enough water is 
then added to make the 4-ounce solution. 

As there seems to be a great deal of misunderstanding about the 
use and meaning of the word " ad," it has been suggested by some to 



EXTEMPORANEOUS PRESCRIPTIONS. 135 

discard its use in prescriptions altogether, but it would seem to be 
absurd to drop an exceedingly expressive and convenient term for 
the purpose of accommodating ourselves to the ignorance of others. 
A better plan is to use the word only in connection with the abbrevia- 
tion " q. s.," which would make the last line of the last example 
read thus : 

Aquae q. s. ad f 5 iv. 

Used in this manner, it is hardly possible that any one should mis- 
understand the meaning of this convenient preposition. 

The choice of diluent should never be left to the dispenser, but 
should always be expressed in the prescription, so that the prescrip- 
tion may always be compounded in exactly the same manner. 

Combination of Kemedies. 

It will prove of great interest and value to the reader to carefully 
study the classical work of Dr. Paris, entitled "Pharmacologia," but 
as this work is out of print and very scarce, and, therefore, inaccessi- 
ble to most readers, no apology is needed for inserting here the fol- 
lowing synopsis of the chapter from Dr. Paris' work, which bears 
the heading, "An Analysis of the Objects to be Attained by 
Mixing and Combining Medicinal Substances." 

Medicines are combined to achieve different results : 

I. TO PROMOTE THE ACTION OF THE BASIS OR PRINCIPAL MEDICINE. 

A. By combining several different forms, or preparations, of the same 
substance. 

This is of use when the chemical nature of the medicinal substance 
will not admit of the full solution of all its active principles in any 
one solvent, and its exhibition in substance is ineligible. Example: 
Liquor iodi composite*, in which iodine and iodide of potassium both 
are necessary to effect proper solution. Unguentum iodi illustrates 
the same truth. 

B. By combining the basis -with substances of the same nature— that is, 
which are individually capable of producing similar effects, but with less 
certainty or energy than when in combination with each other. 

Dr. Paris says that Dr. Fordyce first proved that a combination of 
similar remedies will produce a more certain, speedy, and consider- 
able effect than an equivalent dose of any single one. 

A number of examples have already been given. This fact is es- 
pecially observable in regard to the action of 

(a) narcotics; 

(b) bitter tonics; 



136 THE PRESCRIPTION. 

(c) aromatics; 

(d) astringents; 

(e) emetics (as ipecac with tartar emetic") ; 
(/) antispasmodics (as valerian with ether) ; 
(g) cathartics; 

(Ji) diuretics (as digitalis with acetate of potassium) ; 

(i) diaphoretics; 

(j) expectorants (as senega with squill) . 

It is not so advisable in the case of diffusible stimulants, because, 
by giving them singly, we may economize our resources in lingering 
diseases. This is also occasionally true in regard to narcotics, en- 
abling us to avoid the continual increase of dose and, possibly, con- 
sequent establishment of habit by now and then changing from one 
narcotic to another. 

C. By combining the basis with substances of a different nature, and 
which do not exert any chemical influence upon it, but are found by experi- 
ence to be capable of rendering the stomach, or system, or any particular 
organ, more susceptible of its action. 

Examples have been already given, as when tartar emetic in nause- 
ant doses promotes subsequent absorption of quinine, etc. Changes 
of diet or habits also illustrate this point. 

II. TO CORRECT THE OPERATION OF THE BASIS BY OBVIATING ANY 
UNPLEASANT EFFECTS IT MIGHT BE LIKELY TO OCCASION, AND WHICH 
WOULD PERVERT ITS INTENDED ACTION AND DEFEAT THE OBJECTS OF 
ITS EXHIBITION. 

A. By mechanically separating, or chemically neutralizing, the offend- 
ing ingredient. 

Illustrated in deodorized tincture of opium (separation of narcotine 
and odorous matter) . 

B. By adding some substance capable of guarding the stomach or sys- 
tem against its deleterious effects. 

Instances: Small doses of opium added to emetics will not prevent 
emesis, but will prevent excessive depression and nausea; mucilages 
with pungent substances ; castor oil with turpentine when given as an 
anthelmintic; etc. 

III. TO OBTAIN THE JOINT OPERATION OF TWO OR MORE MEDI- 
CINES. 

A. By combining those substances ichich are calculated to produce the 
same ultimate effects, although by totally different modes of operation. 

Example : Digitalis and acetate of potassium combined in a diuretic 
draught; opium and ipecac in Dover's powder, etc. 

B. By combining medicines which have entirely different powers, and 
which are required to obviate different symptoms, or to answer different 
indications. 



EXTEMPORANEOUS PRESCRIPTIONS. I37 

(a) exhilarants with tonics ; 

(b) antispasmodics with tonics, or narcotics; 

(c) narcotics with excitants (as opium with camphor in paregoric 
or opium with capsicum) ; 

(<f) narcotics with mercurial alteratives; 

(e) tonics with purgatives ; 

(/) astringents with tonics ; 

O) astringents with diaphoretics (as tincture of catechu with tinct- 
ure of ipecac and opium) ; 

(h) astringents with antacids (as chalk mixture with tincture of 
kino) ; 

(0 astringents with narcotics (as acetate of zinc with laudanum for 
injection) ; 

(j) purgatives with narcotics and antispasmodics (as opium with 
sulphate of magnesium in lead colic) ; 

(k) purgatives with excitants and tonics (as ginger with senna, 
compound extract of colocynth with nux vomica, etc.) ; 

(0 purgatives with mercurial alteratives (as aloes with calomel) ; 

(m) purgatives with diaphoretics (not often used); 

(n) diuretics with tonics; 

(0) diuretics with excitants (as squill with carbonate of ammo- 
nium) ; 

(j>) diuretics with alterants; 

(q) diaphoretics with tonics; 

(r) expectorants with tonics; 

(s) expectorants with excitants (as senega with carbonate of am- 
monium or camphor) ; 

(0 antacids with carminatives, tonics, purgatives, or sedatives; 

(11) autilithics with narcotics, diaphoretics, or tonics. 

No rules can be given for these various combinations, but the phy- 
sician must have a thorough knowledge of materia medica and thera- 
peutics, together with varied experience and good powers of observa- 
tion, to make the best use of such combinations. Dr. Paris says that 
a work may give a general idea of the subject, but practice and expe- 
rience alone give full possession of it. 

IV. TO OBTAIN A NEW REMEDY NOT AFFORDED BY ANY SINGLE SUB- 
STANCE. 

A. By associating medicines which excite different actions in the stom- 
ach and system, in consequence of which new or modified results are pro- 
duced. 

Example: Opium is narcotic and ipecac is emetic; pulvis ipecacu- 
anha et opii is diaphoretic. 

B. By combining substances which have the property of acting chemi- 
cally upon each other, the result of which is the formation of new com- 



138 THE PRESCRIPTION. 

pounds, or the decomposition of one or more of the original ingredients 
and the development of their more active elements. 

Examples: Black wash; yellow wash; solution of citrate of magne- 
sium; etc. 

C. By combining substances between which no other chemical change is 
induced than a diminution or increase in the solubilities of those princi- 
ples which are the repositories of their medicinal virtues. 

Examples: Adding acids to the water when making decoction of 
cinchona, or acetic acid to solution of acetate of lead. 

V. TO AFFORD AN ELIGIBLE FORM. 

A. By which the efficacy of the medicine is enhanced. 

Example : Subnitrate of bismuth acts better when given in a mixt- 
ure with mucilage than when given in pill form. 

B. By which its aspect or flavor is rendered less objectionable. 

C. By which it is preserved from spontaneous decomposition, or any 
other chemical change. 

Examples : Iodide of iron is preserved by the sugar in the syrup ; 
sugar in Vallet's mass; boric or salicylic acids as anti-fermentatives ;. 
etc. 

Perhaps no man more carefully analyzed the relations of ingredi- 
ents in prescriptions to each other than did Dr. Paris, and by studying- 
the above abstract from his work in connection with what was pre- 
viously said, and then practicing by analyzing in like manner the pre- 
scriptions on a druggist's prescription file, or in some formulary, 
the reader may soon acquire a thorough knowledge of the combina- 
tions useful in prescriptions. 

Subscription and Signature. 

The subscription or instruction to the druggist is generally very 
simple, as it is presumed that the pharmacist knows his business and 
does not require minute instructions. 

Generally the abbreviations for subscription and signature are 
written in one line, "M. S.;" the letter "M." (jnisce) implying all 
the manipulations necessary to compound the prescription, and the 
letter "S." (signal directing the druggist to label as follows. 

Sometimes this abbreviation is written "M. D. S.," which means 
"misce, da, signa" (mix, give, and sign); or, better, (i misce, detur 
signatura" (mix, let it be given with the signature). 

The signatura, or direction for the patient's guidance in using the 
medicine, should always, if possible, be written in the language best 
understood by the patient or his attendants, or otherwise in plain 
English; never in Latin. Complicated Latin subscriptions and signa- 
tures are obsolete in this country. 



EXTEMPORANEOUS PRESCRIPTIONS. 130 

Finally, the prescription should contain the name of the physician, 
his full address and his office hours, that a druggist may consult him 
if any error should have occurred in writing the prescription. 

The methods of writing the subscriptions for special preparations 
will be considered further on under the appropriate headings. 

Doses. 

The dose of a drug, as stated in the works on materia medica, is 
generally understood to be that quantity which will produce the full 
effect of the remedy. 

The dose of opium, for instance, is stated to be 1 grain, and this is 
the quantity usually required to produce sleep or to relieve pain in an 
adult patient. This dose may be given at once, or in divided portions 
— sometimes called " fractional doses" — at certain intervals, accord- 
ing to the effect required. Opium is better given in full doses if we 
desire to produce sleep; in fractional doses to relieve pain. 

Or, quinine is better given in a full dose as an antipyretic, and in 
broken or fractional doses as an antiperiodic, or as a tonic. 

Some medicine-, especially of the class of haematics, exert no ap- 
preciable effect from the single medicinal dose, and then the frequency 
of repetition is ordered after the dose, as when we say, the "dose of 
tincture of chloride of iron is from 10 to 30 minims, which may gradu- 
ally be increased to 1 or even 2 fluidrams, two or three times a day." 
(United States Dispensatory.) 

The doses, as given in the books, are for adult males in the prime 
of life. Females, aged persons, and youths require somewhat smaller 
doses; children mueh smaller doses. The condition of the individ- 
ual will have much to do in determining the dose, as some women 
may be stronger than some men, etc. Temperament, disposition, 
idiosyncrasies, condition of pregnancy, lactation, etc., all must be 
considered, not only in the choice of the medicine, but also in the 
choice of the dose. 

Doses for Children. 

Children require considerably smaller doses than adults, but there 
is no perfectly accurate rule by which to fix the doses for the little 
patients. The best and most frequently employed rule, which gives 
approximately good results, is Young's, and is as follows: 

"Divide the age of the child, in years, by the age of the child plus 

twelve." 

4 4 1 

If the age is four years, the dose is jj^j-^^T' The d0S6 ° f * 
child of four years is, therefore, one-fourth that of an adult. 



140 THE PRESCRIPTION. 

Dr. R. 0. Cowling's rule is to aclcl 1 to the age of the child in years, 
and divide by 24. If the child is 3 years old, add 1, which makes 4, 
and divide by 24, which gives */24j or Vfi- 

Dr. E. H. Clark assumes 150 pounds to be the average weight of an 
adult and to require the unit of close. Persons weighing more or less 
require proportionately more or less medicine at each dose; there- 
fore, divide the weight of the person in pounds by 150 to learn the 
dose. A person 200 pounds heavy would require 200 /i5o, or */3> of the 
ordinary unit of dose. A child 30 pounds heavy would require 3 %50> 
or i/ 5 , of the unit of dose. 

Unusually Large Doses. 

Occasionally apparently excessive quantities of dangerous remedies 
are prescribed, as of morphine in the case of opium-eaters, or of 
opium in cases of delirium tremens or of peritonitis, etc. To avoid 
delay, on account of justifiable hesitation on the part of the pharma- 
cist to put up such prescriptions, the physician should write the quan- 
tity both in Latin numerals and in words, the latter either in English 
or Latin, in parentheses, thus: 

R— Opii pulv. , gr. iv (four grains). 

Tart, emetic, gr. ii (two grains). 

Sacch. alb., gr. x. 
M. et div. in pulv. III. 
S. : One powder every hour. 

This shows that the large doses are not written by error, but deliber- 
ately and knowingly, and the pharmacist would be justified in putting 
up the medicine unhesitatingly. 

Apparently excessive doses may also be designated by placing an 
exclamation mark in parentheses after the quantity, but care should 
be taken to write plainly, so that this mark may not be confounded 
with the Roman numerals. It has been suggested to underscore the 
large quantity, but this is not a good plan, because the stroke of a 
" t," in the next line below, may be accidentally written under an un- 
intentionally excessive dose, and may lead the druggist to consider it 
all right, and an accident may be the result. The first-mentioned 
method is plainest and, therefore, best. 

Apparent Discrepancy in Stating Doses. 

In a pharmaceutical journal there was published some time ago an 
article by a pharmacist which presents a subject for consideration 
that is often ignored or not properly understood. This writer said 
that pharmacists, not physicians, should fix the doses of pharmaceut- 



EXTEMPORANEOUS PRESCRIPTIONS. HI 

ical preparations, as they were better acquainted with the percent- 
age strength of the various preparations. This view is held by many 
pharmacists, and, while it is not the province of these pages to treat 
at length on this subject, a few words will not be out of place. 
The above-quoted assertion shows that the writer did not understand 
the principles that govern the determination of doses, for many ques- 
tions of therapeutics and pharmacy, besides the mere consideration of 
percentage proportions, are involved. 

In Bartholow's work on Materia lledica and Therapeutics the fol- 
lowing doses of two preparations of ipecac are given, and the number 
of grains of the drug contained in each dose is added in parentheses: 

Fluid extract of ipecac. Dose: ITI ii— 5 i (2— 60grs.). 
Wine of ipecac. Dose: III i — 3 i (Vie — ± grs.). 

Any given volume of wine of ipecac contains only about Vis as much 
of the drag as an equal quantity of fluid extract of ipecac, yet the 
small' stated is only half as large, or contains V32 as much 

ipecac as the small se of fluid extract, while the largest 

OJ the wine given by this author is of equal volume as that of the 
fluid extract, but contains only ; ; as much ipecac. 

Now, ac< to the views of the writer mentioned above, this 

shows hum nt; i the part of Bartholow^, and the work 

of fixing the d lid have been delegated to a pharmacist. That 

Bartholow knew this difference in strength is shown by his calling 
attention to it himself; nevertheless he gives the above doses. The 
truth Is, these two preparations are used for entirely different pur- 
poses; and, in fact, the difference inaction between large and small 
3 of ipecac is alm< - at as if they were two different reme- 

dies. Ipecac in lar - (15 to <;o grains) is used as an emetic, or 

in son . and with due precautions, as an anti-dysenteric rem- 

edy; Id small doses (1 ".-„, to 2 or 3 grains) as expectorant and nause- 
ant, and in some Intestinal troubles of children. For the emetic 
effects the fluid extract or powder is used; for the other effects, in 
cough mixtures, etc., the milder syrup or wine is preferred. We 
would not waste 2 lluidounces of good sherry wine to give 1 dram of 
ipecac as an emetic, especially as the dilution would delay the action; 
and when we do not wish the emetic effects we make the remedy 
more pleasant with syrup or wine; and the doses of the preparations 
quoted in the works on therapeutics are the doses an intelligent and 
educated phvsician makes use of, for the purposes for which the prep- 
aration is best adapted. Numerous similar instances might be quoted, 
but the above are enough to show that the apparent discrepancies in 
the doses of different pharmaceutical preparations of the same drug 
are not due to ignorance of the composition on the part of physicians, 



142 THE PRESCRIPTION. 

but are based rather on long experience and sound therapeutical 
knowledge, and an appreciation of these facts enables the physician 
to choose intelligently from among these various preparations. 

Cases have no doubt come to the knowledge of every one in which 
the patient was treated by one physician for a length of time unsuc- 
cessfully, and then promptly recovered under a change of physicians; 
and yet both physicians used the same remedies. This is often as- 
cribed to "faith," or "imagination," on the part of the patient, and 
occasionally this may be the explanation, but in most such cases it is 
due to greater knowledge on the part of the second physician, w T ho, by 
judicious choice of preparations and doses, is able to produce grada- 
tions and modifications of effects of which some physicians and many 
pharmacists seem to have no idea. A physician may write grammat- 
ically faultless prescriptions, and yet fail to produce the desired 
effects if he has neglected the study of the subject suggested in this 
paragraph. 

Prescribing. 

When the physician has carefully examined the patient and arrived 
at a diagnosis, if such is possible at the time of the examination, the 
next thing is to determine on a plan of treatment, and to write the 
prescription. The latter should not be done until after a full exam- 
ination, as it destroys the confidence of the patient if the physician 
commences to write the prescription and then throws it aside, half- 
finished, upon hearing the patient state a symptom not before men- 
tioned. The patient is excusable, under such circumstances, if he 
thinks the physician hasty and careless, and that he does not fully un- 
derstand the case; or, if hie begins three or four prescriptions before 
finishing one, it gives the patient the impression that he is ignorant, 
and undecided in regard to the proper treatment; and in either case 
he need not be surprised if he never sees his patient a second time. 

Having determined, as far as possible, the nature of the case, we 
determine what to give. This our knowledge of materia medica and 
therapeutics enables us to do, and base, adjuvant, corrective or direc- 
tive, excipient, and diluent are all mentally determined on. Then 
comes the question, how, or in what form, to give. This is by no 
means a subordinate question, for the efficacy and promptness of our 
treatment often depends upon the determination of this point. 

As a general rule, we may remember that medicines dispensed in a 
fluid form act most promptly and surely, and in the pill form most 
slowly, if not most unsatisfactorily. Whenever the powers of assimi- 
lation are low or interfered with by the disease, or when the symp- 
toms are urgent, it is folly to give solid preparations, unless they are 
almost instantaneously soluble in water or in the gastric juice. Pow- 
ders and pills that require time to dissolve or digest, often lose us 



EXTEMPORANEOUS PRESCRIPTIONS. 143 

our patients, when the same remedies in fluid form might have saved 
them. The writer's experience has been that the fluid extracts are 
usually the best form in which to administer drugs when promptness 
and certainty of action are desired. 

When the remedy may be given in several forms — as, for instance, 
in solution, pills, or powders— without sacrifice of efficiency, we may 
give to our patient a choice of these preparations, as individual tastes 
differ in this regard, some preferring pills or powders, while others 
prefer solutions. 

The next question is, how much to give. This, also, depends on 
many different circumstances. Some remedies are given in a single 
dose, as emetics, cathartics, etc.; while others, such as tonics, etc., 
are given in divided doses, more or less frequently repeated. In the 
latter case we should give such a quantity, that, if the patient takes 
the remedy according to our directions, it will be sufficient from one' 
of our visits to the next. The number of hours in a day during which 
a patient will take medicine averages about sixteen, as the other 
eight hours are consumed in sleep. It is very seldom necessary to 
rouse a patient to take medicine, as sleep is generally of as much im- 
portance as drugs. 

Dividing sixteen by the number of hours of interval between the 
administration of the separate doses, and adding one, we find the 
number of doses to be given for each day; it is then easy to deter- 
mine the total number of doses from one of our visits to the next. If 
we visit the patient on alternate days, and he takes a dose of medi- 
cine every three hours, he will take six doses (16-^3 = 5; 5 + 1 = 6) 
in one day; and we will, therefore, prescribe twelve doses at each 
visit. In such calculations we, of course, ignore fractions. 

This calculation is only approximately correct, as the patient may 
sleep more or less than eight hours, or his tablespoon may contain 
less than jounce, etc.; so that we need not be so very exact in this 
calculation of the number of doses. 

It is very much to the disadvantage and injury of the physician if 
he prescribes large quantities of medicines— for which the patient 
must pay, of course— and then at the next visit orders the use of the 
remedy to be discontinued, though scarcely half is taken, and pre- 
scribes something else. 

It quite frequently happens that a row of half-empty vials and 
boxes adorns the patient's table, looking, as the patient sometimes 
expresses himself, "like a small drug store." This is justly regarded 
by people in moderate or poor circumstances as a waste for which 
there is no excuse, and which they can illy afford. If the physician 
dispenses his own remedies, they will suspect him of an effort to in- 
crease the bill unnecessarily; or, if he does not dispense medicines 
himself, they will think he is paid a percentage on his prescriptions 



144 THE PRESCRIPTION. 

by the druggist. This, of course, no reputable physician will stoop 
to take, and the pharmaceutical profession have no very flattering 
opinion of the men who are avaricious and mean enough to ask per- 
centages. 

In the struggle for existence only the fittest should survive, and 
when a physician or a druggist can not exist without receiving or 
paying percentages he ought to learn a trade, or do something to earn 
an honest livelihood. 

There may not be any improper motive in prescribing too large 
quantities of medicines, and it may be simply from a want of reflec- 
tion, or from thoughtlessness ; yet the physician who is in the habit of 
prescribing a fresh remedy before the old is taken will surely suffer 
in his practice. 

Unforeseen symptoms may occasionally arise which will call for a 
change of remedies, and in such an exceptional case, of course, the 
above considerations should not prevent us from making the change. 

When writing a prescription, we first write the names of the drugs 
or ingredients in their proper order; for example, when called to pre- 
scribe for a child suffering with " summer complaint," and we wish 
to give powders, each containing 1 grain of mercury with chalk, y 2 
grain of Dover's powder, 2 grains of subnitrate of bismuth, and 4 
grains of sugar — 1 powder to be given every two hours, and the visit 
to be repeated next day — we will write : 

R— Hydrargyri cum creta, 

Pulveris ipecacuanha compositi, 
Bismuthi subnitratis, 
• iSacchari albi, 

Misce et divide in pulveres 
Signa: 1 powder every two hours. 

Now, we calculate sixteen hours a day for taking medicine, and two 
hours interval between doses (10-^2=8; 8 + 1 = 9); nine doses to 
be given. 

In prescribing powders (or, in fact, any other preparation) it is cus- 
tomary to employ only even numbers to express a number of doses 
greater than three; we, therefore, give eight or ten doses. Suppose 
we give ten doses. We write the numeral X after the word pulveres 
in the subscription, and then multiply the intended dose of each in- 
gredient by ten, writing the quantities thus ascertained after the re- 
spective names, and the prescription is as follows : 

R— Hydrargyri cum creta, gr. x. 

Pulveris ipecacuanhas compositi, gr. v. 

Bismuthi subnitratis, gr. xx. 

Sacchari albi, gr. xl. 

Misce et divide in pulveres X. 
Signa: 1 powder every two hours. 

We must be careful, however, to write the required quantity of each 
drug after the name of that drug, and not after some other name. Sup* 



EXTEMPORANEOUS PRESCRIPTIONS. H5 

pose that we intended to give 1/40 part of a grain of strychnine and 2 
grains of quinine in pill form in each pill, it would not be " quite the 
thing" to change the quantities, thus: 

R— Strychninae sulphatis, 9 iv. 

Quininae sulphutis, gr. i. 

Mucikiginis tragacanthae, q. s. 
Misce et divide in pilulas XL. 

Such carelessness might lead to very serious results; for, although 
the above is perhaps an exaggerated example, mistakes of this kind do 
sometimes occur. While the above method of writing a prescription 
is usually employed, this should preferably all be done and calculated 
mentally, the drugs, together with their order and quantities, being de- 
termined before commencing to write. In such a case the prescrip- 
tion is written out in full at once. 

When the quantity of any ingredient is near some such weight as 
a scruple, dram, or ounce, a half-scruple, half-dram, or half -ounce, 
or some multiple of these quantities, we prefer to use the sign for 
Mich quantities Instead of the exact number of grains. We also pre- 
fer to say 3*4, rather than £)lss, or gr. xxx. The sign gss is chosen 
rather than Jir, etc.; josl as we would say one dollar, and not ten 

When writing a prescription for any other preparation, liquid or 
solid, we proceed just as for powders; first determining the drugs, 
then the number of doses, then the total quantities desired. 

Having finished the prescription we carefully read it over, assuring 
ourselves of the con of our doses aud calculations, and then 

we give it to the patient, giving him full oral instructions how to use 
the medicines, besides ordering plain directions to be written on the 
label. 

Bome physicians are In the habit of writing prescriptions in which 
they designate the ingredients by unusual names, not understood by 
every pharmacist, thus forcing the patient to go to a druggist who has 
come to an agreement with the physician in regard to these private 
formula?. The patient is thus, perhaps, compelled to go a great dis- 
tance to a drnggist in whom he places no confidence, and who will 
Charge high prices for simple substances because the patient can not 
have the prescription compounded elsewhere. Such collusions be- 
tween the drnggist and physician are entered into for the purpose of 
cheating the patient, and such behavior is unprofessional, and parties 
thereto are guilty of quackery and fraud. 

Influences Modifying Action of Medicines. 

Works on therapeutics give information in regard to many influences 
which modify the action of medicines and the size of doses, all of 
which must be borne in mind when prescribing. 



14:6 THE PRESCRIPTION. 

We have already referred to age as regulating the sizes of doses. 
But it also must be considered as regards action of medicines. Opi- 
ates and narcotics, cathartics, and many other remedies are either not 
given to children at all, or only in very small doses, far less in pro- 
portion than as ascertained by the rules already given; while, on the 
other hand, calomel is borne in proportionately larger doses without 
producing salivation. 

The sex of the patient also exerts a great influence on the action of 
medicines. The general rule that women require smaller doses than 
men was probably based on an empirical experience, which was 
afterward formulated by Dr. Clark into a rule, already quoted, ac- 
cording to which the unit of dose is to be given to patients weigh- 
ing 150 pounds, and larger or smaller doses in proportion to the 
greater or lesser weight of the patients. As the average weight of 
women is less than the average weight of men, the average doses 
for women are also less; but a definite rule, applicable to individ- 
ual cases, has never been formulated, and probably can not be formu- 
lated. Some authors, however, have stated that neurotics, or nerve 
remedies, and cathartics, especially if of the gastro-intestinal irritant 
class, must be given with greater caution to women than to men. 

Perhaps much of the difference of the action of medicines, as ex- 
erted upon persons of different sexes, is due less to the sex than 
to the different habits of women and men. As a rule, men use 
liquors, tobacco, spices, sauces, and other stimulating articles of 
food or drink to a much greater extent than women do ; the latter 
generally preferring more insipid or simply sweet food and drink. 
Therefore, when we prescribe remedies to affect the nerves or ali- 
mentary canal, the man, who is used to the habitual stimulation of 
these organs, will not be affected by the same doses that would prob- 
ably act violently on most women. The habits of the individual, there- 
fore, have a greater modifying effect on the action of medicines than 
the sex. Habit, indeed, may enable a person to consume immense 
quantities of some drugs, as we see in the tolerance of opium, arsenic, 
and other remedies, in those who are addicted to these vicious " hab- 
its." The long-continued use of almost any remedy will accustom 
the patient to its use, and necessitate continually increasing doses, 
unless the use of the remedy is occasionally discontinued. 

The time of day when to administer medicine is sometimes of im- 
portance. Thus, most cathartics should be given late at night, so 
that they may commence and finish their expected action during next 
day. It is not advisable to disturb the sleep of the patient, or com- 
pel him to get out of bed to go to the closet, as by so doing he may 
"take cold," and more mischief than good may follow the use of 
the remedy. 

Many remedies may irritate an empty stomach which would be 



EXTEMPORANEOUS PRESCRIPTIONS. U7 

easily borne on a full stomach, or at least before the meal is totally 
digested. Cod-liver oil is better tolerated when taken with a meal 
than when taken on an empty stomach. Of course, such remedies as 
pepsin, alkalies, acids, etc., given before or immediately after meals 
to influence the digestion of the food, would do little or no good if 
given when the stomach is empty. Generally, large doses of most 
liciues are best given two or three hours after meals; cathartics, 
narcotics, and hypnotics in the evening; saline purgatives and diuret- 
ics, especially in the form of mineral waters, in the morning; etc. 

The season of the year also influences us in the choice of remedies 
and doses. In winter, for example, when much larger quantities of 
more solid diet are taken, we can give larger doses of cathartics than 
in summer, when more vegetable and fluid substances are ingested, 
and most persons are inclined to suffer from the summer diarrhoeas. 

Similar considerations influence treatment as practised in various 
Climates and zones, and on individuals of different races. The influ- 
ence which race has on the action of medicines is not as much dwelt 
on as the subject probably demands. We know that there are pecul- 
iar exemptions from some veil as peculiar susceptibilities 
in regard to others, on the part of different races, and even of differ- 
ent people, and it is hut fair to suppose like differences of suscepti- 
bility to the action ol medicinal agents. The effect of alcoholic liquors 
on the Indians of North America is well known, as is also the extent 
of the opinm -eating habit am< og Mongolian people. It seems to.be 
a fact that the higher civilized and cultivated races, as well as indi- 
viduals, require and tolerate greater amounts of nerve-stimulants 
(alcohol, etc.), while the use of narcotics (opium, hasheesh, etc.) is 
more extensively practiced by the so-called " half-civilized " nations; 
the apparent exception to this— namely, the increased use of opium, 
hydrate ol chloral, chloroform, cocaine, etc., in civilized countries or 
communities, In recent times— is directly traceable to the perhaps 
well-meant, although ill-judged and often fanatical prohibition and 
total-abstinence movement, which is unintentionally forcing a greater 
curse on the country than the one it is trying to suppress. 

Individual idiosyncrasies produce quite exceptional conditions, 
which no physician can foretell, but the possibilities of which must 
not be lost sight of in prescribing. For instance, a single dose of 
mercury will salivate some persons; or of iodine will produce cuta- 
neous eruptions and coryza; or of quinine may cause choleraic symp- 
toms, or, as in a recently reported case, extensive desquamation of the 
skin; a small dose of opium may produce mania, or excessive narcot- 
ism; etc. On the other hand, in other patients and under other con- 
ditions, very lame quantities of medicines may be given. Instead of 
being a personal idiosyncrasy, this may be only a consequence of 



U8 THE PRESCRIPTION. 

the particular disease ; as when we give immense doses of opium in 
peritonitis, or apparently enormous quantities of hydrate of chloral in 
delirium tremens. 

Incompatible^. 

By i 'incompatibility" in a prescription we mean that the combina- 
tion of certain substances or remedies is objectionable or impossible; 
and this incompatibility may arise from various reasons. 

We may classify cases of incompatibility under four headings : 

I. Mechanical Incompatibility. 

II. Organoleptic Incompatibility. 

III. Chemical Incompatibility. 

IV. Therapeutical Incompatibility. 

A thorough knowledge of materia medica and chemistry is neces- 
sary to avoid the error of combining incompatible substances in the 
same prescription, and the physician should carefully study this part 
of materia meclica in the works on that subject. It is probably im- 
possible to make a list which would be of much value, as the list 
could not be memorized, and reference to it when perhaps the patient 
is looking on, or when away from home on a visit to the patient, is, 
of course, out of the question. We will, therefore, confine ourselves 
in this place to the consideration of the general facts only, leaving it 
to the prescriber to apply these facts to the individual characteristics 
of the remedies he desires to give. 

Considering, first, then, mechanical incompatibilities, we find that 
there are many remedies which we can not bring into as homogeneous 
union as would be desirable, but that the resulting mixture would soon 
separate again. Tinctures containing iodine, volatile or fixed oils, 
balsams, oleo-resins, resins, resinoids, and similar substances form 
precipitates when they are added to water, and these precipitates 
often adhere so persistently to the sides of the vial that shaking will 
not loosen them, and the liquid that might be poured from the bottle 
would contain little or none of the medicinal ingredients. 

Often, in cases of this kind, we may correct the trouble by making 
the menstruum in our prescription more alcoholic by adding either 
plain alcohol or one of the alcoholic liquors; provided, of course, 
that the use of alcohol is not counter-indicated by the condition of the 
patient. 

Many cases of mechanical incompatibility may be corrected by proper 
pharmaceutical manipulation, or processes, as when we cause the pre- 
cipitate to be a light, flaky one, by adding the tincture slowly to water 
during constant trituration, or perhaps by adding syrup instead of 
water alone, thus suspending the resulting precipitate and making a 






EXTEMPORANEOUS PRESCRIPTIONS 149 

" shake mixture;" or, when we emulsify an oil by me^ a oi acacia 
or yolk of egg> and thus overcome an apparent mechanical incom- 
patibility. 

Mechanical incompatibility is least likely to do actual harm to the 
patient, but it is most apparent to the pharmacist, who is often an- 
noyed by combinations that defy his utmost skill in dispensing. The 
right of the pharmacist to alter the prescription under such circum- 
stances is limited, and the prescription, if really not compoundable, 
should be referred back to the physician for correction. A merely 
trifling change — such as the substitution, in a prescription for pills, of 
one excipient which will make a mass for another which was pre- 
scribed and will not make a mass — may, of course, be permitted. 

Organoleptic incompatibilities are such as result in medicines, offen- 
sive to sight, taste, or smell. Reference to the methods of correct- 
ing some of these errors by means of excipients has already been 
made when speaking of the latter. Certain mixtures are so disagree- 
able, however, that we should avoid them altogether, if possible; for 
instance, tincture ol al m a in a mixture is rarely prescribed now, 
aloes being almost always administered in pills. 

Preparations containing tannic acid produce such unsightly mix- 
tures with iron salts .Unions that we generally avoid the com- 
binations. 

Examples of chemical itibility are quite plentiful. Two or 

more substances may be added to each other, and unite to form a new 
compound; or, by double decomposition, several new compounds, 
which may be entirely different from the original substances pre- 
scribed. Such resulting compounds may be insoluble and inert; or 
they may be exceedingly active or even poisonous; or they may have 
therapeutical or physiological effects which are totally different from 
those which the prescriber desired. 

It is generally stated that alkaline hydrates or alkaline carbonates 
should not be mixed with acids. While this is generally true, yet 
the resulting salts may be just what we want to give, as in the "neu- 
tral mixtures, " or "saturations;" as when we order carbonate of am- 
monium and benzoic acid "ad saturationem," so that the solution con- 
tains benzoate of ammonium, or as in solution of citrate of mag- 
nesium. 

As a rule, alkaline hydrates and carbonates should not be added to 
soluble alkaloidal salts, as the latter may become decomposed, pre- 
cipitating the often insoluble alkaloid. This, while it generally does 
not detract from the activity of the alkaloid, gives rise to the clanger 
that the last dose may contain an excessive amount of the alkaloid and 
produce serious results which would have been avoided by the reten- 
tion of the alkaloidal salt in solution. Metallic salts should not be 



15U THE PRESCRIPTION 

given with ai^aiine hydrates, carbonates, chlorides, sulphides, etc., 
because precipitates may result; as nitrate of silver with chloride 
of sodium, or calomel with lime-water. Even to this rule there are 
exceptions; for calomel with lime-water gives us "black wash," while 
corrosive sublimate with lime-water forms "yellow wash," both of 
which are valuable remedies. 

It will be seen from the above that there are many cases of chemical 
incompatibility which can not be objected to on therapeutical 
grounds; that, in fact, many of these "incompatible" combinations 
are valuable from a therapeutical standpoint, and that it is, therefore, 
impossible to give general rules as to which combinations may or 
may not be used. This will depend on the ingredients, and each 
prescription must be considered individually. 

There are, however, some chemically incompatible mixtures which 
must never be prescribed — namely, those in which decomposition may 
take place violently, or with explosive force. 

The most dangerous combinations that are likely to occur in pre- 
scriptions are those of chlorate of potassium, permanganate of potas- 
sium, bichromate of potassium, chromic acid, or concentrated mineral 
acids, with easily oxidizable organic substances. 

We should avoid giving chlorate of potassium with tannic acid, 
glycerin, sugar, sulphur, hyposulphite of sodium, etc. Chlorate of po- 
tassium will explode violently with many other substances, either 
upon trituration or spontaneously, but some of these mixtures are 
extremely unlikely to be prescribed ; as chlorate of potassium with sul- 
phide of antimony, picrate of ammonium, picric acid, etc. 

Nitrate and permanganate of potassium may explode with the same 
substances which are dangerous with chlorate of potassium. 

Nitric acid may produce spontaneous combustion or explosion with 
turpentine or other oils; or some of the concentrated mineral acids, 
as sulphuric and nitric, may produce the same result with simple 
syrup. We should, therefore, make it a rule to prescribe chlorate or 
permanganate of potassium only in solution, and, as far as possible, 
without other ingredients except water ; as it may occur that the vial 
is left uncorked, and the water evaporates, in which case the residue 
might explode. Chlorate of potassium troches, ignorantly carried 
loose in a pocket which contained matches, have produced violent 
explosion. Mineral acids should not be prescribed in a concentrated 
form, but only diluted. A safe plan is to prescribe no combinations 
which are unusual, without first studying the results that may possibly 
occur; and, if explosive or poisonous compounds may be formed, we 
should, of course, avoid them. 

In dispensing, we must recollect that many substances, such as 
vapors of ether or alcohol, lycopodium dusted in the air, etc., are in- 



EXTEMPORANEOUS PRESCRIPTIONS. 151 

flammable, and, with air, form explosive mixtures. It is crue these 
are not spontaneously inflammable, but require the presence of a 
flame to ignite them; but at night a physician requiriug an anaes- 
thetic will prescribe chloroform, and not ether, on account of the 
danger of igniting the vapor of the latter. 

To consider therapeutical incompatibilities at any length is outside of 
the scope of these pages, and we must refer to those works on ma- 
teria medica and therapeutics which treat at length on the physiolog- 
ical action of medicines. By therapeutical incompatibility is meant 
an antagonism in action, so that one ingredient of the prescription 
acts as an antidote to another. Such antagonisms are not infre- 
quently met with, sometimes even in official preparations, as in the 
case of tincture of coniuin, in which the alcohol is an antidote to the 
conium, and to a certain extent interferes with the proper action of 
the drug. A combination of opium with cathartics would ordinarily 
be considered incompatible; yet, in lead colic, a solution of sulphate 
of magnesium with tincture of opium is found in practice to be a 
very valuable combination. 

Belladonna (or its alkaloid, atropine) is a physiological antidote to 
opium, and is used in cases of opium poisoning. Opium is a power- 
ful depressant of the heart's action, while atropine, in proper doses, 
is a most energetic heart stimulant. Both, in excessive doses, are 
narcotic poisons. Notwithstanding the above-mentioned physiolog- 
ical antagonism or incompatibility, it is found in practice that a com- 
bination of the two remedies produces anodyne and hypnotic effects, 
without the danger of narcotic poisoning from either. It appears, 
therefore, even in regard to physiological incompatibility, that expe- 
rience or empiricism teaches us that there may be exceptions; and we 
may do well to remember that there can not be any positive rules in 
regard to this whole subject of incompatibility, but that we must 
study the characteristics of the individual drugs in this, as well as in 
all other regards. 

Another subject, somewhat related to chemical incompatibility, is 
that concerning the changes of color produced by various combina- 
tions in our prescriptions. It is important to think of the possibility 
of such changes — not so much, perhaps, because they can affect the 
value of the medicines, but rather because a want of knowledge in this 
regard may lead us to express or form erroneous and unjust opinions 
as to the correctness of compounding, and our own ignorance may 
cause us to do injustice to some able pharmacists. 

Lessing gave the following examples of color chan ges, in his work on 
materia medica. Sulphurous acid, chlorine water, or any preparation 
containing free chlorine or bromine, may bleach organic colors con- 
tained in syrups, tinctures, etc. Sunlight, or strong alkalies, or 



152 THE PRESCRIPTION. 

acids, may nave a similar effect. Bromine and iodine, however, may 
change some Of the colors to yellow, brown, or blue. 

Red vegetable colors become brighter with acids, or change to an 
orange tint, while alkalies often change them to brown or green ; me- 
tallic salts sometimes precipitate them. 

Yellow vegetable colors become darkened upon adding alkalies; 
acids have comparatively little effect, while metallic salts may make 
them paler. 

Orange or brown vegetable colors are affected similarly to the red 
or yellow colors. 

Green vegetable colors change to yellow with acids, and to yellow- 
ish-brown with alkalies. 

Blue and violet vegetable colors generally become reddened with 
acids, and brown with alkalies. Litmus is an exception, it becoming 
blue with alkalies. 

These changes of color are most apparent in solutions, although 
some of them are noticeable in powders, etc.; as when w T e mix rhubarb 
with alkaline carbonates, or with anise oil. 

They are unimportant, except as already explained, and a change of 
color will not deter us from prescribing any otherwise desirable com- 
bination. 

Special Preparations. 

In the remaining pages of this Part we will consider the applica- 
tion of the foregoing general principles to the prescribing of special 
preparations, such as pills, powders, solutions, etc. The physician 
should aim to write his prescriptions in such complete form, includ- 
ing the designation of the comparatively unimportant excipients, 
diluents, conspergatives, etc., that the medicine will be exactly of the 
same appearance, taste, and smell, no matter how often, or by how 
many different pharmacists the prescription may be compounded. 
Medicines may be dispensed in solid or liquid forms, and of these we 
will consider the following: 

Solid. 

Species (teas) . Suppositoria (suppositories) . 

Pulvis (powder in bulk) . Unguenta (ointments) . 

Pulveres (powders). Cerata (cerates). 

Confectiones (confections). Emplastra (plasters). 

Trochisci (troches). Chartce (papers). 
Pilulce (pills). 



EXTEMPORANEOUS PRESCRIPTIONS. 158 

Liquid. 

Solutiones (solutions). Misturce (mixtures). 

Saturationes (neutral mixtures). Emulsiones (emulsions). 

Infusa (infusions). Enemata (injections). 

Decocta (decoctions). Linimenta (liniments). 

Species (Species, ierum, f., pi.). 

These have already been considered in former pages. They are pre- 
scribed by enumerating the ingredients, and writing either concisus, a, 
urn (cut), or contusus, a, urn (crushed), after the names of the vege- 
table substances, according to the nature of the drug, thus: 

R— Hyoscyami concisi, 5 ss. 

Lini farinae, % viii. 
Mi ft. spec. S. : 

It must be recollected that teas, cataplasms, baths, pillows, etc., 
are prescribed and dispensed as " species.'* The subscription for 
these preparations is simple: M. ft. spec, (misce et fiant species, mix 
and let species be made.) 

The signature should give explicit directions for the use of these 
species; for instance: 

Make a poultice of it. 

A handful in a quart of boiling water to make tea. Drink freely. 
Boil 2 handfuls in 3 gallons of water; when cool, use as sponge bath. 
Boil in 1 gallon of water; .strain; when cool, use as injection. 
Sew in a muslin bag, and apply warm to cheek. 

For a dry pillow, to apply to cheek, about 1 or 2 ounces of species 
is required. Cut narcotic herbs are usually mixed with cut chamo- 
mile, elder flow r ers, or hops as diluents ; or we order only the active 
species, and direct in the signature to mix with a certain quantity of 
bran or corn meal. 

When dry heat is to be applied to an extensive surface, as to the 
abdomen, from 3 to 10 ounces of species may be required for the sack 
or pillow 7 ; if chamomile or hops forms the bulk of the species, less is 
needed than if corn meal forms the bulk, about twice or three times as 
much of the latter being required as of the former lighter substances. 

Poultices may be made from linseed meal, corn meal, bread crumbs, 
or powdered slippery elm bark, with hot water or milk. They may be 
made anodyne by adding narcotic herbs to the species; or tincture of 
opium, or fluid extract of belladonna, henbane, or conium, to the poul- 
tice; cooling or soothing, by adding solution of subacetate of lead; 
stimulating, by adding powdered mustard to the species, or sprinkling 
turpentine on the prepared and folded poultice; deodorizing by add- 



154 THE PRESCRIPTION. 

ing vegetaoie charcoal to the species; or disinfectant by adding car- 
bolic acid, etc., to the poultice. When fluids are to be added to the 
poultice, these are prescribed separately and dispensed in vials as 
solutions. 

For a medium-sized poultice, the bulk of which consists of linseed 
meal, about 4 ounces of species will suffice, and we give the attend- 
ants verbal instructions to mix this with about % pint of boiling 
water, to make a stiff paste, which is to be folded in a thin piece of 
muslin and applied to the skin, so that one thickness of the muslin 
intervenes between it and the poultice mixture. To apply a poultice 
direct to the skin is a filthy and otherwise objectionable practice, as 
the subsequent cleaning of the skin is troublesome and oftentimes 
positively injurious. It is customary to prescribe two pillows or two 
poultices, so that one may be warmed while the other is applied. 

The quantity of species required for a bath depends in part on the 
character of the drugs. For a bath for full immersion, for an adult, 
about 2 pounds of species are required; less, of course, for a bath 
for children. For a sitz-bath, foot-bath, or sponge-bath, % pound of 
species will usually suffice. The bath is directed to be prepared by 
boiling the required amount of species in a few gallons of water, 
allowing to stand for ten or fifteen minutes, straining, and then add- 
ing to the water in the tub. The whole bath should then be brought 
to the proper temperature before the patient is placed in it. 

The cold bath should have a temperature of about 20° C. (68° F.). 
It is seldom medicated. 

The tepid bath, or lukewarm bath, should be from 24° C. (75° F.) to 
35° C. (95° F.), or somewhat less. 

The warm, or hot bath, is from 35° C. (95° F.) to 41° C. (106° F.). 

The lukewarm and hot baths are frequently medicated. 

Never allow the boiling medicated decoction to be added to the bath 
after the patient is already in it; thoughtless attendants have occasion- 
ally scalded patients to a fearful extent in this manner. 

The mustard bath is to be made by filling a tub with warm (not hot) 
water to the desired depth ; from 1 to 4 ounces of mustard is tied in 
a piece of muslin, and, after soaking, is alternately squeezed and 
soaked until its virtues are imparted to the water. The patient is 
then placed in the bath, and the cloth with mustard is used like a 
sponge for rubbing the skin. When the surface is sufficiently red- 
dened, the patient is taken out, dried quickly, folded in a sheet and 
blanket, and laid in bed. If the mustard is thrown loosely into the 
water, countless particles will remain adherent to the skin, and each 
one will continue to smart and burn, and thus completely destroy the 
soothing effects of a properly prepared mustard bath. 

If the species are to be used for inhalation, about 2 ounces are 



EXTEMPORANEOUS PRESCRIPTIONS. 155 

thrown into a quart of boiling water, and the patient inhales the ris- 
ing steam and vapors, but from a safe distance, so as not to scald 
himself. The steam may be kept up for some time, either by occa- 
sionally throwing hot pebbles into the water or by setting the vessel 
on the stove, avoiding active ebullition. Such inhalations of vapor of 
chamomile, hops, tincture of henbane, belladonna or opium, of tar, 
creosote, etc., or even of water alone, often give great relief in 
colds, catarrhs, influenza, bronchorrhoea, bronchitis, and other simi- 
lar troubles. 

Powders 

are dry drugs divided into small particles which are easily movable 
upon each other. They may be of different degrees of fineness, but 
the only kinds used in prescriptions are those of impalpable fineness. 
The following drugs are fit for administration in powder form: 

1. Drugs too bulky for pills, as carbonate of magnesium, etc. 

2. Insoluble drugs, as calomel or calcium phosphate. 

3. Drugs incompatible in solution. 

4. Vegetable extracts and blue mass, when dry. 

5. Drugs very bitter or nauseous in solution. 

6. Almost all salts, and alkaloids and their salts. 

7. Soft or even liquid substances, if incorporated with a proper 
quantity of absorbing vegetable powder or sugar. 

The following kinds of substances are not well adapted for admin- 
istration in powder form: 

1. Nauseous drugs, as asafetida. 

2. Deliquescent salts. 

3. Salts containing much water of crystallization, unless previously 
dried, as sulphate of iron. 

4. Very volatile substances, as musk, camphor, etc. 

5. Soft extracts or extract-like substances. 

6. Acrid substances, as carbonate of ammonium. 

To these general statements some exceptions may be noted. Nause- 
ous or volatile drugs, for instance, may be given in wafers or gelatin 
capsules; or volatile substances may be dispensed in waxed paper, 
and soft substances may be mixed with dry vegetable powders, etc. 

Powders may be dispensed in bulk, the close being measured out 
with some approximate measure; or in divided doses, each dose 
folded in a separate paper. 

Powder in Bulk (Pulvis, eris, m. orf.). 

When the dose of the powder exceeds 20 or 30 grains, it is best pre- 
scribed in bulk, with sugar as a diluent. It should be dispensed in a 



156 THE PRESCRIPTION. 

wide-mouthed bottle or in a paper box, and the dose is measured, 
when wanted, with a teaspoon or other appropriate measure. 

For the purpose of approximating the doses, powders may be classi- 
fied: 

Light: Magnesia and vegetable powders ; teaspoon contains 7 to 
30 grains. 

Moderately heavy: Resins, gums, sugars, sulphur, and the lighter 
salts; as alum, chlorate of potassium, chloride of ammonium, cream 
of tartar, etc.; teaspoon contains from 30 to 60 grains. 

Heavy: Metallic oxides and salts (rarely given in bulk) ; teaspoon 
contains from GO to 120 grains. 

The teaspoon is supposed in these cases to be moderately heaped; 
if only level full, it contains about half as much. 

The method of prescribing is shown in the following example : 

R— Sennae pulveris, 

Potassii bitartratis, 

Sulplmris loti, aa, §i. 

Zingiberis pulveris, 3i. 
M.; ft. pulv. S.: 

The subscription in this case may be simply M. (jnisce, mix) if 
all of the ingredients are already in fine powder; or, if any of the in- 
gredients are in lumps or crystals, as follows: M.; ft. pulv. Qnisce; 
flat pulvis — mix; let a powder be made). 

We may add to this, d. in scatul. (detur in scatula; let it be given in 
a paper box), or d. in vitro {detur in vitro; let it be given in glass), if 
for any reason we find it necessary to do so. 

The following medicines are most frequently given in this form: 
Mixtures of powders containing pepsin, subnitrate of bismuth, etc., for 
dyspeptics; charcoal, magnesia, phosphate of lime, carbonate of lime, 
cubebs, cream of tartar, sulphur, lupulin, powdered senna, etc. 

Sugar is usually added as a diluent, and may be flavored with a 
volatile oil, when it is called "oleosaccharum," thus: 

R-Bismuthi subnitratis, g ss. 

Oieosacchari menthae piperita?, | iiss. 
M.; d. in vitro. S.: 

This means that volatile oil of peppermint shall be added to the 
sugar in the proportion of about 1 drop for every dram (or, accord- 
ing to some, for every scruple), and then be thoroughly mixed. The 
whole is ordered to be dispensed in a glass vial, because the oil of 
peppermint is volatile and might evaporate from a paper box. 

It may be recollected that with 20 grains of one of the light powders 
there can be mixed, 

of an extract of pill consistence to 6 grains ; 

of an ordinary extract to 4 grains ; 

of a balsam or oleo-resin to 4 drops ; 



EXTEMPORANEOUS PRESCRIPTIONS. 157 

of a volatile oil to 4 drops; 

and of a watery substance, if the powder is insoluble in 

water, to 2 grains; 

With an equal quantity of a moderately heavy powder only half as 
much of the above substances can be incorporated. 

The above method of prescribing powders in bulk is not very accu- 
rate in dosing, and is useful only when substances are to be given for 
a long time and when the doses need not be very exact. 

Powders in Divided Doses (Pulveres, m. or f ., pi.). 

When accuracy in dosing is necessary, the powders are divided into 
exact doses, each of which is folded in a small piece of paper, called 
chartula. The contents of such a paper should weigh from i to 10 or 
15 grains, and when the dose is much smaller than 4 grains, some in- 
ert powder is added as a diluent, for ease of division. This diluent is 
generally sugar or sugar of milk; but other substances, as aromatic 
powder, etc., are also used. 

In writing the prescription, the whole quantity of each drug is writ- 
ten; the ingredients are directed to be mixed, and then to be divided 
into the desired number of doses. 

K— opii pulveris, gr. ii. 
Aculi tannic!, 3 88. 
iiaii albi, 5 i. 
M. et div. inpulv. XII. S.: 

This form of subscription, Misce et divide in pulveres (mix and 

divide into powders), is very simple, yet explicit, and therefore 

sufliciently complete. 

Other formulae may be employed, of which the following are, per- 
haps, most common. 

M. et div. in part. aeq. (misce et divide in partes aequales , 

mix and divide into equal parts) ; or, instead of the term part. 

aeq., the term chart, (chartulas, papers), or dos. (doses, doses), may 
be written. 

M. et ft. pulv.; div. in chart. (misce et fiat pulvis; divide in 

chartulas , mix and let a powder be made ; divide into papers) , 

is a form of subscription especially adapted to prescriptions with one 
or more of the ingredients in the form of lumps or crystals or in any 
form other than a powder. 

After the word misce, in any of the above formulae, the word et is 
generally omitted, although it would be better to retain it. 

Powders are sometimes prescribed thus : 

R— Opii pulveris, gr. 1/6. 

Acidi tannici, gr. iiss. 

Sacchari albi, gr. v. 
M. etft. pulv.; d. tal. dos. XII. . 



158 THE PRESCRIPTION. 

Jlisce etfiat palvis; dentur tales doses XII (mix and let twelve such 
powders be given). This subscription means that twelve powders 
are to be given, each (talis, e, adj.) powder containing the quantities 
named in the prescription. In this case, the dispenser multiplies 
the quantity of each ingredient by the number of powders stated in 
the subscription, to ascertain the total quantity which he must weigh 
out. This method it is not advisable to adopt, as it adds another 
chance for error in dispensing. 

A very common error, which should be carefully guarded against, 
is to write the subscription thus: M. ft. pulv. No. III. This form 
of subscription does not make it clear whether the druggist shall divide 
or multiply the quantities named in the subscription, and, while he 
would generally guess correctly, it is, nevertheless, only a guess Mi 
each case. M. ft. pulv. is correct when only one powder is ordered, 
but when two or more powders are prescribed, it should be div. in 
pulv., instead of ft. pulv. The word "No." is superfluous. We da 
not say " divide into number three powders," nor did the Komans. 

If the powders contain a volatile substance, they may be wrapped 
in waxed papers, which are prescribed by adding to the ordinary sub- 
scription the formula, d. in chart, cerat. (dentur in chartulis ceratis y 
let them be given in waxed papers) . 

Or, to disguise the taste of disagreeable medicines, they may be pre- 
scribed in gelatin capsules, by adding d. in capsul. gelatin, (dentur in 
capsulis gelatinatis, let them be given in gelatin capsules), or, in wa- 
fers, d. in chart, amyli (let them be given in starch wafers). 

Some physicians prefer to write in plain English, "Put up in cap- 
sules," or, "in wafers," to which there is no serious objection. 

The patient may be directed to take soluble powders in water or 
milk, etc., or insoluble powders in more viscid liquids, as in syrup; 
or he may place the dry powder on the tongue and gulp it down with 
a mouthful of water. 

If the powders have been put up in capsules or wafers (the latter 
also sometimes called "cachets"), these are dropped into a glass or 
cup containing a large tablespoonful of water, milk, coffee, or other 
fluid. In a moment, wiien the entire surface has been moistened and 
softened, the whole contents of the glass or cup is swallowed at one 
gulp, without breaking the wafer or capsule. 

Or the patient may be instructed to put up his medicine in a wafer, 
himself. Wafers may be bought either round or square. One of these 
is dipped edgewise into water, so as to wet its whole surface, and is 
then laid on a large, previously wetted, tablespoon. The powder, 
pill, or bolus, is then laid on the wafer; and then first one edge is 
folded over, then the opposite, to overlap the first; then the ends; 
after which the spoon is filled with water or milk, and the whole swal- 
lowed at one gulp. 



EXTEMPORANEOUS PRESCRIPTIONS. 159 

With care, even castor or cod-liver oil can be inclosed in a wafer in 
this manner, and swallowed without any perception of taste. 

Confections (Confectio, onis,i.). 

This class of preparations is occasionally useful to make disagree- 
able remedies more palatable, especially for children. Powders are 
mixed into a paste with honey, preserves, fruit, jellies, or syrups, any 
one of which may be prescribed q. s., the amount necessary to be 
taken being left to the judgment of the dispenser. 

Soluble powders, such as salts or sugar, are not appropriate for 
administration in this form, unless the quantity of insoluble powders 
in the prescription is largely in excess. 

Official confections are prescribed by writing the name and the 
quantity merely. Extemporaneous prescriptions for confections 
enumerate the powders or other ingredients, and, lastly, an excipient 
to make the mass. 

H— 8antonicaB pulveris, % i. 

J&laps pulveris, 5 §8. 

Rosas confectlonis, q. s. 

m. 1 t it. oonfect. 8 



(Misce etfiat confectio, mix and let a confection be made.) 
Confections are sometimes divided into conserves (conserva, ce, f.), 
and electuaries {electuarium y f, n.), the first being made by mixing dry 
sugar with a m<>i>t vegetable substance, the second by mixing dry 
vegetable powder with a moist or liquid saccharine substance. It is 
unnecessary to moke the distinction in the subscription. 

Tills (Pilula, ce, f.). 

In order to make pills, it is necessary to make a mass of a doughy 
consistence, small portions of which can be rolled into a round shape, 
which they should retain, neither flattening nor becoming brittle and 
crumbling by age. 

As the size of the pill is limited to an average weight of 2 to 6 
grains, and as a patient usually does not like to take more than half a 
dozen for a dose, we can not well give drugs in pill-form when the 
dose exceeds 15 to 20 grains. 

Deliquescent salts should not be prescribed in pill-form; neither 
liquid substances, unless the dose is very small; as carbolic acid, 
creasote, or croton oil. 

The following drugs are suitable for administration in pill form 
(mainly after Parrish) : 

1. All drugs suitable to be given in powder, if the dose is small enough. 



160 THE PRESCRIPTION. 

2. Resins and balsams, which may be made into a mass by adding 
soap or other excipient. Copaiba can be warmed with its own bulk, 
each, of powdered cubeb and yellow wax; and, when melted and well 
mixed, the mass resulting on cooling may be rolled out into pills. 

3. Substances, the action of which is to be retarded. On the other 
hand, medicines designed to act promptly must not be given as pills. 

4. Insoluble substances, too heavy to be given in mixtures. These may 
also be given in powder. 

5. Disagreeable or nauseous substances. These are very pleasantly 
disguised in pills, especially in the coated varieties ; they may also be 
given in powders, which can be dispensed in capsules or wafers. 

6. Vegetable extracts and blue mass. When vegetable extracts are too 
soft, it may be necessary to add some inert vegetable powder, as pow- 
dered marshmallow root, to make a sufficiently dry mass. 

7. Volatile oils and oleo-resins may be made into pills with the 
proper excipients, but they are better given in capsules. 

In prescribing pills it is necessary to have some adhesive substance 
to allow the making of a mass. Often the base becomes adhesive 
upon the simple addition of a few drops of water; or an adjuvant or 
corrective may be indicated which is itself adhesive or becomes so 
with a small quantity of water. 

R— Nuc. vomic. extr., gr. v. 

Belladonn. extr., gr. viii. 

Colocynth. extr., comp., 5 i. 
M. et div. in pil. XXX. 

When water alone will suffice, as in this prescription, to make a 
mass, this is not usually expressed in the prescription. The same 
prescription, however, would be better written : 

R—Nuc. vomic. extr., gr. v. 

Belladonn. extr., gr. viii. 

Colocynth. extr., comp., 3 i. 

Aquae q. s. ut ft. mass. 
M. et div. in pil. XXX. 

The simplest subscription being best, provided it is explicit enough, 

the formula M.; div. in pil. , is preferred by the writer. Of course, 

the direction misce; divide in pilulas , implies in the word misce, 

the making of a mass, as otherwise it could not be divided into pills. 

In the last example of prescription, above, it is really only neces- 
sary to write aquad q.s., as the additional remark, utfiat massa, is nec- 
essarily implied in the subscription. 

A common form of subscription is M.; ft. mass.; div. in pil. 

{misce; fiat massa; divide in pilulas — — , mix; let a mass be made; 

divide into pills); or, M.; ft. mass, in pil. div. (misce; fiat 

massa in pilulas dividenda, mix ; let a mass be made, to be di- 
vided into pills) . 



EXTEMPORANEOUS PRESCRIPTIONS. 161 

The defective forms of subscription already condemned for pow- 
ders are still more frequently used for pills: M.; ft. pil. No. , 

or, Ft. pil. (sometimes abbreviated to Mfpil. ). No., for 

number, is superfluous; ft. pil. is appropriate when 1 pill only 

is to be made; otherwise it is always preferable to write, divide in 
pilulas . 

The following list of excipients for pills is mainly after Eemington : 

Water — used only when the ingredients of the pill possess sufficient 
adhesiveness to be developed by the water. 

Syrup — similar to water; a little more adhesive. 

Syrup of acacia — more adhesive than simple syrup ; pills are apt to 
become hard in time. 

Mucilage of acacia — more adhesive than the last. 

Glycerin — a little of it in a pill prevents the pill from becoming 
hard . 

Glucose — colorless; adhesive, very generally useful; best excipient 
for quinine. 

Honey — similar to glucose; not colorless. 

Extract of malt— similar to glucose; not colorless. 

Glycerite of starch— more adhesive than glycerin alone; does not 
allow the pill to dry out hard. 

Glycerite of tragacanth— similar to above ; more adhesive. 

Confection of rose— useful when we want to increase bulk of mass. 

Crumb of bread— useful to make pills from such liquids as croton 
oil, volatile oils, carbolic acid, etc. 

Powdered althaea— added to give proper pill consistence to soft ex- 
tracts, etc. 

Soap — with resins. 

Besin cerate— valuable for oxidizable substances, etc. 

Cacao butter— for permanganate of potassium pills and similar sub- 
stances. 

Petrolatum — same as above. 

Vegetable extracts— solid extracts of couchgrass, dandelion, gentian, 
etc., form good masses with vegetable powders and quinine. 

In choosing the excipient, it may be remembered that resins are 
often best made into a mass with powdered soap and water. If much 
of vegetable powders is in the prescription, any of the mucilages will 
do right well; or honey, syrup, confection of rose, or one of the 
above-named extracts; glucose makes a good mass with quinine; 
some resins are easily made into a mass with alcohol, but the pills 
are apt to flatten unless some vegetable powder is added. 

After a little study of the nature of the medicines, the proper excipi- 
ent can readily be chosen, and should always, if possible, be named 
by the physician. As he can not always determine the exact quantity 



1G2 THE PRESCRIPTION. 

necessary to form a mass, it is customary to prescribe " q. s." of the 
excipient, thus : 

R— Acid, arsenios., gr. ii. 

Quin. sulph., 5 ss. 

Extr. gentian., q. s. 
M. et div. in pil. XXX. 

If all of the medicinal ingredients of a pill-mass are resinous, res- 
inoid, or extractive substances, the pills are apt to flatten; and, there- 
fore, it is well to add for each pill from y 6 to >£ a grain of powdered 
licorice root, or of some other vegetable powder, the fibers and cell- 
walls of which afford mechanical support and maintain the globular 
form of the pill. The quantity should be written in the prescription 
by the physician, as this addition affects the size of the pills. 

As a general rule, a small addition of licorice root, not enough to 
materially increase the si ze of the pill, together with extract of gen- 
tian, will make a good pill-mass; and, in fact, this extract of gentian 
is one of the most generally useful pill excipients. 

When it is desirable to make pills from a very small quantity of 
medicine, as when we desire to make 60 pills from 1 grain of strych- 
nine, the prescription requires three ingredients — the base (just men- 
tioned] ; a diluent, or powder, to increase the bulk and euable us to 
divide the base into doses, and an excipient to cause the other ingre- 
dients to adhere or form a mass. These subordinate ingredients of 
the mass should be mentioned in the prescription, as it is desirable 
that the prescription should be so complete that the pills made ac- 
cording to it will always have the same size and color, thus : 

R— Strychninse sulphatis, gr. i. 

Glycyrrhizge pulveris, gr. xv. 

Glycyrrhizae extracti pulveris, gr. xx. 

Aquae, q. s. 

M. et div. in pil. LX. 

As a diluent, the physician may prescribe starch, aromatic powder, 
powder of licorice root, cinnamon, or marshmallow, or any other 
medicinally inert powder. 

But no prescription for pills is quite complete unless the consper- 
gative is also mentioned, and, as the color and taste of au extempo- 
raneously prescribed pill depends almost altogether on the adhering 
powder, this should always be designated by the physician; and it 
will be in this matter, as in so many others, that a judicious choice 
and variety will avoid the appearance of mere routine in prescribing 
pills. This conspergative is written after the subscription, or rather, 
it is the concluding part of the subscription: 

R— Quin. sulph., gr. xl. 

Oleoresin. piper., gr. v. 

Ferri redact., gr. xx 

Extr. gentian., q. s. 
M. et div. in pil. XX. 
Consperge ly copodio . S . : . . . . 



EXTEMPORANEOUS PRESCRIPTIONS. 163 

Here the direction, consperge lycopodio (sprinkle or strew with lyco- 
podium), directs that when the pills are being cut and rounded they 
shall be rolled in lycopodium to prevent adhesion. Aromatic pow- 
der, cinnamon, marshmallow or licorice root powders, etc., are good 
conspergatives for dark-colored pills, while a mixture of starch and 
powdered sugar, or lycopodium, answers better for light-colored 
pills. A prescription for pills, written with proper diluent and ex- 
cipient, and with the conspergative mentioned, will, of course, nec- 
arily cause pills of the same size and appearance to be put up 
whenever and however often it may be compounded. 

Formerly, before sugar-coated and gelatin-coated pills were in use, 
it was the habit, frequently, to order pills to be gilded or silvered. 
This may be prescribed by writing, instead of consperge lycopodio, as 
in the above example, as follows: 

Obduc. foi. atari (obducantur fuliis auri, let them be covered with 
leaves of gold), or obduc. fol. argenti (of silver). 

Probably, theoretically, the must promptly active and reliable pills 
are extemporaneously prepared and uncoated pills, when made from 
fresh, first-class ingredients by a competent dispenser. But in the 
actual practice of the present time, the finest and most accurately 
made pills are well-finished gelatin-coated pills, made on the large 
scale by reliable manufacturers. The gelatin-coated pill must be still 
soft while it is being coated; and the coating, which is of extreme 
thinness, dissolves readily on the tongue, swelling, as it does so, and 
rendering the pill so slippery that it is readily swallowed; and, as the 
coating is either tasteless or sweet, the disagreeable taste of the pill- 
mass is entirely disguised. 

The coating being also perfectly transparent, the peculiar color of 
the pill-mass is clearly shown, and, therefore, mistakes from substi- 
tution are less liable to occur, and the appearance of routine prescrib- 
ing is avoided by the great variety in the size and color of the pills. 

Ready-made gelatin-coated pills are prescribed, either by writing 
the maker's name for the pills, together with the abbreviation of the 
manufacturer's name, as in the following example (O-W.L. standing 
for the name of the maker, the Oldberg-Wall Laboratory) : 
R— Pil. quininac, phosphori et ferri, O-W.L., xxiv. 
or by writing the manufacturer's formula, thus: 

R— Quininas sulphatis, gr. i. 

Phospbori, gr. i/ioo- 

Ferri carbonatis massaa, gr. i. 

In pil. I. 

D. tal. pil. XXIV (O-W.L.). 

This subscription, dentur tales pilulas viginti et quatuor (O-W.L.), 
means, let 24 such pills, of Oldberg-Wall Laboratory's make, be given. 



164 THE PRESCRIPTION. 

If the firm whose name is mentioned makes pills with only one kind 
of coating, it is not necessary to designate the coating in the prescrip- 
tion. Otherwise the style of coating is usually specified in English, 
in parenthesis, after the number of pills. 

When the physician prescribes ready-made, coated, or "proprie- 
tary" pills, as in the last example above, by enumerating the active 
ingredients instead of merely the name of the pills, it is of course 
unnecessary to state either the diluents or excipients, as these are not 
under the control of the dispenser. But this remark applies only 
when the name of the manufacturer is mentioned, as otherwise the 
pills, as dispensed by different pharmacists, may present great diver- 
sity of appearance. 

The bolus is simply a very large oval pill, 10, 15, or more grains in 
weight. Boluses are prescribed exactly like pills, merely substitut- 
ing the abbreviation bol. for pil. in the subscription. They are usu- 
ally taken in wafers or gelatin capsules. 

Tablet, Lozenge, or Troche (Trochiscus, i. m.). 

Usually round, oval, or octagonal discs, punched out of a mass, 
like pill-mass, which is rolled out much in the same manner as pastry 
dough, and then dried. They are rarely prescribed to be made ex- 
temporaneously, but are ordered by designating one of the official or 
commercial varieties, and the number desired ; thus: 

R— Trochiscos soclii santoninatis XII. 
S.: 

Occasionally it may be necessary to prescribe troches extempora- 
neously, and, if so, the mass is ordered similar to pill-mass, and the 

subscription is M. et div. in trochisc (misce et divide in trochiscos 

, mix and divide into troches) . 

As the troches must be dried, they can not be made so as to be dis- 
pensed on short notice, and this may be the reason why they are so 
seldom prescribed extemporaneously. 

Suppositories (suppositorium, i. n.). 

Suppositories are medicines incorporated with oil of theobroma, 
formed into conical shape, and intended for rectal administration, 
either for local or general effect. Occasionally suppositories are used 
for introduction into the vagina or urethra, but these are rarely pre- 
scribed extemporaneously; proprietary articles of this kind are 
usually called for and dispensed, and these are often made with gel- 
atin. 



EXTEMTORANEOUS PRESCRIPTIONS. 165 

The Pharmacopoeia directs that, unless otherwise prescribed, each 
suppository shall weigh 15 grains, or 1 gram. The prescribing is 
therefore, very simple. After writing the names and quantities of the 
active ingredients, add oil of theobroma to make the total mass weigh 
as many times 15 grains as the number of suppositories desired, thus: 

R— Extr. opii aquos., gr. iii. 

Acid, tannic. , gr. xviii. 

01. theobroime, q. 3. ad 5 iss 
M. et div. in supposit. VI. 
Gonsperge lycopodio. 

The conspergative (usually lycopodium or starch) should be men- 
tioned, as some druggists are in the habit of packing suppositories 
in cotton, the libers of which often are difficult to remove, and may 
produce irritation. 

Plasters (EmpUutrum^ i. n.). 

are hard when cool, but become adhesive at the tempera- 
ture of the body. They are usually spread on muslin, chamois skin, 
Sheepskin, adhesive plaster, or other suitable fabric, warmed and 
^polled cither for local effect in skin clis- 

Ct od deepei lying organs. 

Ordinary Lead or adh< 3 peons' plaster," is used for 

giving mechanical - ipport in the treatment of injuries, fractures, dis- 

- 

Plasters ma] tally be prescribed by weight (about 10 grains 

fox be covered), but they are generally 

• ■ — thus: 
d— | mnae, i"x 6". 

These flgor< 9, accompanied by the sign for inches, mean of course 
a plaster, 4x6 Inches In bi 

Cbrai b (Ceratum, i. n.). 

3 solid than ; designed for use as dressings on lint, 

charple, muslin, etc. They are generally prescribed by weight, and 
dispensed in gallipots. Sometimes, as in the case of cantharidal cer- 
ate, they are prescribed like plasters-by size. In an extemporane- 
ous prescription for a cerate, various substances may be ordered to 
be mixed with simple cerate as the vehicle or diluent. The subscrip- 
tion is Jf. etft. cerat. (mUce et fiat ceratum, mix and let a cerate be 
made). 

If all the ingredients are already cerates, as when a more active 
cerate is ordered to be mixed with simple cerate to reduce its 
strength, the subcription is simply M. (misce, mix). 



166 THE PRESCRIPTION. 

Ointment (JJnguentum^ i. n.). 

Softer than cerates; melt at the temperature of the body, by fric- 
tion. They are designed for inunction. They are prescribed pre- 
cisely like cerates, simply using the abbreviation ungt., instead of 
cerat, 

Papers (Charta, ce.f.). 

There are three of these preparations official in the Pharmacopoeia. 
In two, charta cantharidis, and charta sinapis, one side of a sheet of 
paper is coated with appropriate preparations containing the respect- 
ive medicinal agents; while in the charta potassii nitratis, bibulous 
paper is saturated with nitrate of potassium. 

The first two are intended for external application, and are pre- 
scribed like plasters, by size, or, as they frequently are kept in pieces 
of about four inches square, by number. They are usually, however, 
in rolls, and the proper size can be cut off. 

The patient, or his attendants, must be instructed to moisten the 
mustard paper by dipping in lukewarm water before applying it. 

The nitrate of potassium paper is cut in strips, which are ignited 
and allowed to burn without flame, and the vapors are inhaled by 
asthmatics. 

Liquid Preparations. 

In dispensing fluid medicines, it is necessary to bear in mind the 
sizes of vials in use, so that these may be filled. The physician should 
so arrange the quantities in his prescriptions that the liquid is not 
too much for one size of vial and too little for the next size, but just 
the right quantity for one or another. 

He must remember, therefore, that % y 1, 2, 3, 4, 6, and 8-ounce vials 
are employed for prescriptions. The next sizes are 10, 12, 16, 24, and 
32-ounce sizes, which are, however, rarely employed for prescriptions. 

Vials of blue or black glass are often employed to dispense reme- 
dies for external application, the color of the vial, with the customary 
conspicuous red color of the label, being an additional safeguard 
against mistakes and accidents. 

Blue vials are often used to dispense solutions of nitrate of silver, 
with a Yiew to prevent the action of light upon such a preparation. 
But a moment's thought will show the uselessness of this practice, 
for blue glass transmits the chemical or actinic rays of light, and 
therefore, offers no protection to this sensitive solution. Bottles of 
a deep orange-yellow (" amber") glass are now used for the above 
purpose ; and, as this glass obstructs the passage of actinic rays, these 



EXTEMPORANEOUS PRESCRIPTIONS 167 

vials are very appropriate for all solutions and preparations liable to 
be injured by the action of light. 

When we desire to have any preparation dispensed in a blue or 
black vial (the druggist uses these indiscriminately), we state in our 
subscription, d. in vitr. nigr. (detur in vitro nigro, let it be given in a 
black glass) . 

A yellow vial would be ordered d. in vitr. flav. (flavus, «, urn, yel- 
low) . 

Official, Officinal, and Proprietary Liquid Preparations. 

If it is desired to prescribe any of these preparations without any 
admixture, this is of course readily done by merely writing the name 
and quantity, thus: 

R— Tinct. ferri chlorid., f I i. 


or, if proprietary, by adding the initials of the makers, 

R— Extr. ergot. 11., O-W.L., f 5 ii. 



or if the preparation is usually put up in bottles of a certain size, it Is 
best to write : 

R— Llq. magnes. eitrat., lagenami. 

or, if proprietary, adding the initials of the makers, 

ft— Extr. malticomp., O-W.L., lagenami. 

Lagena is a Latin word, meaning bottle. Instead of one bottle of 
solution of citrate of magnesium, 12 fluidounces maybe prescribed; 
but as this preparation must be put up in " citrate of magnesia 
bottles," which hold just this quantity, neither more nor less may be 
prescribed to be dispensed in one bottle. 

In regard to prescriptions for so-called proprietary medicines, it may 
be stated that, while of course any quantity less than a full bottle 
may be prescribed, it is not always good policy to do so, as the drug- 
gist, in order to secure himself against loss, must often charge 
almost as much for the less quantity as for the whole bottle, and it 
is therefore more economical for the patient, and also often more 
agreeable to the pharmacist if the prescriber orders the whole bottle, 
if possible. 

When only one fluid preparation is ordered in the prescription, 
Without any additions, no subscription is necessary; but if two or 
three different kinds, all fluid preparations, are ordered in the same 
prescription, the subscription is M. (misce, mix). 

If, however, one or more of the ingredients of the prescription for 



168 THE PRESCRIPTION. 

a fluid preparation are solid, or such as will not mix readily with the 
other ingredients, then the subscription is not always so simple, and 
the method of prescribing may also be more difficult. 

Solutions (Solutio, onis, f.). 

By a solution we mean a fluid preparation, consisting of one or more 
solid substances dissolved in water, with or without the addition of 
acids, alcohol, or glycerin. To this may be added other liquids, as 
syrups, tinctures, fluid extracts, etc. A solution is a clear or moder- 
ately clear liquid, without any undissolved floating particles or sedi- 
ment ; the whole of it could pass through a filter. Occasionally the 
addition of some ingredient may cause a slight opalescence without 
destroying its character as a solution. 

The solution may vary in color from watery clearness and limpidity 
to a very deep and almost opaque color. 

R— Quininae sulphat., 5 ss. 

Acid, sulph. dil., q. s. 

Syr. auraut., f 5 i. 

Aquae purae, f § iii. 
M. etft. sol. S-: 

In such a prescription the subscription is simply Misce etfiat solutio, 
mix and let a solution be made. 

When the solid substance requires a special solvent, as in the case 
of quinine, the solvent (acid, in this case,) should be mentioned in 
the prescription. Occasionally we meet such prescriptions: 

R— Quininae sulphat., 3 i. 

Syr. tolutan., f 5 ss. 

Elix. tarax. cornp., f J iiiss. 
M. etft. sol. S.: 

Opinions differ as to the proper method of dispensing this prepara- 
tion. On the one hand, it is maintained that the subscription directs 
a solution to be made, and that this can not be done without an acid ; 
that, therefore, the acid should be added, although it is not men- 
tioned in the prescription. On the other hand, it is argued that the 
evident intention of the prescriber is to disguise the taste of the qui- 
nine with the elixir; and, as this object would be defeated by the ad- 
dition of an acid, the subscription should be disregarded and no acid 
be added. The writer holds the latter opinion, and thinks that the 
intention of the prescriber should be carried out as far as possible; 
but the prescriber should not write ft. sol. when the ingredients will 
not make a solution, and when he evidently did not want a solution ; 
or he should prescribe the necessary solvents, if he actually desired the 
solution to be made. In the above example there is, therefore, an 
error in either case, no matter what was the prescriber's intention j 
either an omission in the inscription, or a wrong subscription. 



EXTEMPORANEOUS PRESCRIPTIONS. 169 

In this example, the solid substance, together with its special solv- 
ent, is so small in bulk in proportion to the total quantity, that its 
bulk may be entirely ignored in calculating the quantities of the 
fluids ; and the syrup has such a simple relation to the total quantity 
that the amount of diluent required is easily determined and also 
easily written in simple terms. 

Frequently, however, this is not the case. The other ingredients 
make such an odd volume that the remainder, which must be filled up 
with diluent, is also so odd an amount that we can not well write it, 
even when we may readily ascertain how much it should be. Or, it 
may be that there are a number of solid ingredients, of which we do 
not know the volume they will occupy in the solution, and, therefore, 
can not calculate the exact amount of diluent to be added. In such 
cases, it is customary to write the preposition ad after the name of 
the diluent, and then the total quantity which it is desired to dis- 
pense. Thus we write as follows: 

R— Opii tincturae, f5ss. 

Valerianae tincturae, f5 iii. 

Syrupi tolutani, 15 vi. 

Aquam puram ad 13 iv. 
M. etft. sol. S.: 

In this case, the quantity of diluent required to make 4 fluidounces 
would be 2 fluidounces and 6^2 fluidrams. Instead of writing this 
odd quantity we obtain exactly 4 fluidounces, and thereby secure ex- 
act dosing, in the manner described. 

One drawback to the above prescription is, that it will not always 
be dispensed in the same manner. This, it is true, is not the fault of 
the prescriber, but of the dispensers. One of the regular " old-relia- 
ble" stock questions for the "Queries and Answers" columns of the 
pharmaceutical journals is, "what does ad mean in prescriptions?'' 
Many druggists would add 4 fluidounces of diluent. 

The writer has, therefore, been in the habit of writing in a some- 
what modified manner : 

R— Magnes. sulph., 5 I. 

Acid, sulph. dil., f 5 i. 

Syr. acid, citric, f 5 i. 

Aquae q. 9. utft. solut. 13 vi. 

M. S.: 

This can not well be misunderstood ; aquas quantum satis at fiant 
solutionis fiuiduncia*, sex (water enough to make 6 fluidounces of solu- 
tion). Instead of this, some would write in this prescription, "aq. 
q. s. adf^vi," which is also not likely to be misunderstood. "Aq. ut 
ft-fo vi " is stiU another method of writing the same thing. 

Although it is not customary to do so, yet it might be a good plan 
to write ali prescriptions for solutions, mixtures, and other similar 



170 THE PRESCRIPTION. 

preparations in which a diluent is used, in the manner just indicated, 
to make up a certain total quantity. We would then avoid all calcu- 
lations as to the amount of diluent necessary, and would insure more 
correct dosing. 

The gargle (gargarisma) , eye-wash (collyrium), injection (injectio) f 
wash or lotion (lotto), etc., are all solutions, and are prescribed a& 
such. 

Neutral Mixtures (Saturatio, onis, f.). 

These are solutions of an alkaline substance in water, neutralized 
or saturated with an acid. Usually carbonates are thus dissolved, and 
the carbonic acid gas liberated is partly dissolved in the water, and 
the resulting mixtures are rendered grateful to the patients thereby; 
this is especially the case when the stomach is rebellious as in cholera 
morbus, in which complaint the following mixture usually controls 
the vomiting and purging quite promptly : 

R— Potass, bicarb., 5 i. 

Acid, tartar. , 

Aquae, aaq. s. utft. saturat. fg iiiss. 
Adde 

Morph. sulph., gr. i. 

Tinct. valerian., 

Syr. sacchari, aa f 3 ii. 

M. S.: Tablespoonful every hour. 

In prescriptions of this kind, it is not to be supposed that the phys- 
ician will always remember the precise quantity of acid necessary to 
exactly neutralize or saturate the base, and he therefore writes q. s. 
after the name of the acid. The form used above for prescribing a 
saturation extemporaneously may be easily remembered : 

R (base; with quantity.) 

(acid . ) 

Aquae, aa q. s. ut ft. saturat (quantity.) 

Adde 

M. S.: 

Any base, acid, and additions can be inserted in any quantities, but 
the form remains the same. In fact, with but very slight change, this 
form answers also for infusions, decoctions, and emulsions, as ex- 
plained further on. 

We may also write the same prescription in another manner: 

R— Potass bicarb., 3 i- 

Acid, tartar., q. s. 

Morph. sulph., gr. i. 

Tr. valerian. ,__ 

Syr. sacchar., aa f 3ii. 

Aquae, q. s. i*d f 5 iv. 
M.: ft. saturat. S.: 

But this is not as well written a prescription as the other. 



EXTEMPORANEOUS PRESCRIPTIONS. 17! 

Infusions. (Infasum, i, n.). 

Made by steeping vegetable substances in either hot or cold water 
then straining. Leaves, soft parts of plants, or substances containing 
volatile principles, may be made into infusions ; and, to the infusion 
other substances may be added. 

It is a habit of many physicians to prescribe infusions without 
mentioning the amount of drug to be used in making them. While 
some pharmacopoeias direct that in such cases, when there is no 
official formula specifying the exact quantities of drug, the latter 
shall be taken in a stated percentage proportion, yet it is better, 
in all cases, to prescribe the exact amount of drug from which a 
certain quantity of infusion is to be made. 

R— Digitalis concis., 3 ss. 

Aquae, q. s. ut ft. infus. f siiss. 
Adde 

Potass, acetat., 3ii. 

Syr. sacchari, fjss. 

K. S.: 

The general outline of the prescription for a neutral mixture is here 
easily recognized, modified but very slightly to adapt it to infusions. 

Decoctions (Decoctum, i, n.). 

Made like the infusion, except that the drug is boiled with water 
for some time, then allowed to cool, and strained. 

Decoctions are prescribed in the same manner as infusions, only 
changing infus. to decoct, in the formula for the prescription or in the 
subscription. Hard parts of plants, roots, rhizomes, woods, barks, 
etc., are made into decoctions, rather than infusions, when a prepara- 
tion of this kind is desirable. Both of these preparations are, how- 
ever, very infrequently prescribed at the present time, other more 
effective preparations, such as fluid extracts, deserving preference in 
most cases. 

Mixtures (3/istura, ae, f.). 

The mixture is not, as the term is sometimes understood, a mixture 
of various substances, but it consists of some insoluble substance 
which is merely suspended by aid of viscid excipients in the diluent in 
which it is dispensed. The United States Pharmacopoeia makes no 
distinction between a mixture of an insoluble powder or of an oil 
with water. We restrict the term "mixture" to the preparations of 
the former kind, and use the term "emulsion" for the latter, thus 
making two classes of the mixtures of the Pharmacopoeia. 

The mixture, according to this definition, is merely a liquid in 



172 THE PRESCRIPTION. 

which an insoluble powder has been suspended, and such a prepara- 
tion requires to be shaken before taking, as the powder soon settles 
to the bottom as a sediment. The official mistura cretce is an example 
of this class of preparations.. Quinine, subnitrate of bismuth, and 
other preparations, are often prescribed in the form of mixtures. 

R— Quininae sulphat., gr. xxx. 

Elix. tarax. comp., f 5 iv. 
M. S.: 

The subscription is merely M. Qmisce — mix). It may be Ft. mist. 
(Fiat mistura, let a mixture be made) as well; but it must not be M. 
ft. mist., as we would have here an inelegant tautology. 

Sometimes the subscription is written "M. Ft." (misce,fiat,) which 
is of course absurd, as/£. must always be followed by the name of the 
preparation to be made. 

All the ingredients are written according to the usual order (base, 
adjuvant, etc.), and this is therefore a very easy preparation to pre- 
scribe. It is somewhat different with the other form of mixture, more 
properly designated as 

Emulsions (Emulsio, onis,i.). 

Emulsions are preparations in which oils, oleo-resins, balsams, res- 
ins, camphor, etc., are suspended in water by means of an excipient, 
which is sometimes termed the emulsifier, or emulgent (emulgens, 
entis, ?i.). 

We have already referred to the two kinds of emulsions, differing 
in the mode of preparation, which have been designated as true and 
false emulsions. 

The true emulsion is one in which the drug contains both the oil 
and the emulgent, as in the official mistura ammoniaci, mistura amyg- 
dala? , and mistura asafoetidce. 

Several seeds furnish true emulsions on being crushed and tritu- 
rated with water; as, for instance, sweet almond seed, poppy seed, 
and hemp seed. Emulsions made from these seeds have little or no 
medicinal value, and are generally used as demulcent vehicles for 
other more active remedies of an acrid nature. 

A prescription for an emulsion is best written according to the gen- 
eral plan already suggested for neutral mixtures, infusions, and de- 
coctions : 

R — Sem. papaveris, 3 ss. 

Aquae, q. s. ut. ft. eniuls. f % iii. 
Adde 

Morph. snlpta., gr. i. 

Syr. amygdalae, f 5 i. 
M. S.: 






EXTEMPORANEOUS PRESCRIPTIONS. 173 

Instead of writing adde, as in above formula, some write cola et 
adde (strain and add) . It is self-evident, however, that such prepara- 
tions must be strained, and to say adde alone is, therefore, sufficient. 
This remark applies also to infusions and decoctions. 

The false emulsion is a more commonly employed form of emulsion 
and consists of the substance to be emulsified, suspended in water by 
means of powdered acacia, yelk of egg, or some other emulgent. To 
the emulsion other substances may then be added, but when acacia is 
the emulgent, we can not add much alcoholic preparations, as the 
alcohol coagulates and precipitates the gum, and thereby destroys the 
emulsion. 

The form of prescription is similar to the above: 

R— Copaibse, f 5 i. 

Acaclad pulveris, 

Aqua;, aaq. 8. ut ft. emuls. f£ ivss. 
Adde 

Spir. aeth. nitros. , 

Tinct. lavandul. comp., aa f 3 i. 

Syr. tolutan., i 5 i. 

M. S.: 

By memorizing the following scheme, and merely writing in the 
proper ingredients and quantities desired, no difficulty will be expe- 
rienced in prescribing emulsions: 

R 

Acacias _pulveris, 

Aqua;, aa q. a. ut ft. emuls 

Adde 

If. S.: 

For instance: 

R— 01. morrhuae, f 3 H- 

Acacia? pulveris, 

Aqua, aa q. s. ut ft. emuls. f 5 vi. 
Adde 

Tinct. opii campli. , 

Byr. pruni virg., aa f 3 i. 

M. S.: 

Or, 

R— Chloroform!, f 3 1- 

Ol. olivaa, f o III. 

Acaciae pulveris , 

Aquas, aa q. s. ut ft. emuls. f 5 iii. 
Adde 

Syr. scillaB, 

Ayr. tolutan., aa f 3 ss- 

M. S.: 

Chloroform may readily be dispensed by mixing with two or three 
times its own volume of best olive oil, and then emulsifying the oil 
with powdered acacia, as if there were no chloroform. The demul- 
cent properties of the emulsion disguise the pungency of the chloro- 
form excellently. 



174 THE PRESCRIPTION. 

There are, of course, other methods of prescribing emulsions; by 
simply enumerating the ingredients, for example, and using a proper 
subscription, thus : 



R— 01. ricini, 

Mucilag. acaciae, 
Syr. sacchar., 
Aquae nienth. ppt. 


i% ss. 

fg iss. 

il ss. 

, f 5 iss. 


M. etft. emuls. S.:.. 





This is a common, but poor method of prescribing emulsions, as 
it implies the use of an inferior method of making the emulsion. It 
would be better to write as follows : 

R— 01. ricini, fg ss. 

Syr. sacchari, f § ss. 

Mucilag. acaciae, 

Aquae menth. ppt., aa q. s. ut ft. f £ iv. 
M. etft. emuls. S.: 

This is better, inasmuch as it leaves the determination of the exact 
quantity of acacia necessary to emulsify to the dispenser, and the 
resulting emulsion will probably be good in proportion as the ability 
of the dispenser is so. 

Rectal Injections (Enema, atis, n.). 

These are very rarely ordered in prescriptions when desired as laxa- 
tives merely, in which case verbal instructions how to prepare them 
are usually given to the attendants. 

It is different, however, when it is desirable to introduce medicines 
in this manner, on account of inability to administer per os, as in ex- 
treme sensitiveness of the stomach, stricture of oesophagus, etc. 

Enemas for the administration of medicines or food, per rectum, 
should be small, 1 or 2 fluidounces at most, if possible, and the medi- 
cines should be dissolved in water, from which they are absorbed much 
more readily than from mucilage or starch paste. Enemas may be 
larger if intended for local effect, as when infusion of quassia is used 
to wash out thread-worms from the rectum. Injections are usually 
prescribed as solutions. 

Liniments (Linimentum, ?', n.). 

A mixture of oily, alcoholic, or other substances intended for ex- 
ternal application, with friction. There is nothing peculiar about 
writing prescriptions for liniments. 

They are often a mixture of incongruous ingredients which will not 
become homogeneous, even on shaking. Nevertheless, they may be 
very effective in this form, but require shaking immediately before 
use. Pharmaceutically, liniments rarely are elegant preparations. 



EXTEMPORANEOUS PRESCRIPTIONS. 175 

In prescribing, we enumerate the ingredients, and say in the sub- 
scription—^, etft. liniment., mix and let a liniment be made. 

Sometimes external applications, resembling lotions or liniments, 
are to be applied with a camel's-hair brush. It has been suggested to 
call them pigmenta, or "paints," but as they are often colorless, it 
would be preferable to apply to them an old term, littus, or litus, oris, 
n. (from the Latin verb lino, 3, to besmear). It is true that this term 
was formerly mainly applied to solutions which were used with the 
probang to paint the tonsils or fauces, but the term would be equally 
appropriate for the preparations now called pigmenta. 

Repetitions {Bepetitio, onis, f.). 

A few words may be added in regard to repetitions. When a phar- 
macist dispenses any prescription, he places on the vial, box, gallipot, 
or other container, a label having, in the upper left hand corner, 
the number of the prescription, according to his file, and on the 
same line, to the right, the date on which the medicine was dis- 
pensed. 

If we desire the prescription to be repeated exactly in the same 
manner, we copy this number and date, and order, for example, as 
follows : 

Bepete No. 32,517, d. 17, VIII, '73. 

Or we may mention the character of the preparation, thus: 

Bepete misturam 5,689, da tarn 13, IV, '77 
Or, 

Bepet. pra?scr. pro pil., No. 7,430, d. 25, VII, '87. 

The adjective datus, a, urn, or its abbreviation d., means "given," 
and the last example would be, in English, " repeat the prescription 
for pills, No. 7,430, (which was) given on July 25, 1887." 

It is almost superfluous to state that such an order for a repetition 
must necessarily be sent to the same pharmacy in which the original 
prescription was compounded, and where it is on file. 

Often, however, it is preferable to rewrite the prescription, even 
when precisely the same medicines are to be given, and to make some 
alteration in regard to the flavoring tinctures or syrups, so as to give 
the preparation a different appearance, taste, or smell. The use of 
variety in this regard may often disguise a most flagrant routine prac- 
tice, or, when a remedy must be continued for a great length of time, 
in chronic or incurable troubles, prevent impatience and dissatisfac- 
tion on the part of the patients and their friends. 



176 the prescription. 

Concluding Remarks. 

After we have finished writing a prescription, we should lay it aside 
for a few minutes, while we give directions in regard to diet and gen- 
eral management. 

Everyone has experienced the facility with which an error, once 
made, will be repeated, unless the mind has been occupied in the 
meantime with some other subject. When, in adding a column of 
figures, we once say, 7 + 5 is 13, we are apt to make this error again 
and again, unless we change and add from above downwards, instead 
of from below upwards, when the mistake will probably be found. 
Book-keepers, in taking a trial-balance, sometimes have a trifling 
error of a few cents, which may elude detection for hours, until the 
tired accountant goes to bed discouraged and disgusted. Next day, 
when the mind is rested, the error is often noticed after a few min- 
utes' search, and one wonders how it was possible that he did not see 
it the evening before. 

A similar experience may happen to the prescriber. He makes an 
error in the dose of some important ingredient, perhaps, and although 
he reads the prescription over several times he notices nothing 
wrong. If he lays the prescription aside for a few moments, during 
which he gives his attention to another subject, and then reads the 
prescription over once more, as if it were a stranger's prescription 
that he desired to criticise, he will almost surely discover the error 
and avert an accident to his patient, and serious injury to his own 
reputation. 

Never deliver a prescription to the patient before having 
carefully and critically examined it, and being sure that 
everything is correct. 

One word more: 

Keep a Case Book. 

It is a good plan to keep a record of all our cases, for easy refer- 
ence. For instance, a patient may be affected with a trouble from 
which he has sought relief from other physicians in vain, until our 
" superior knowledge," (!) or, perhaps, a fortunate accident, has en- 
abled us to give the appropriate remedies. If we make no record of 
his case, file no prescription, then, when he comes to have the medi- 
cine or prescription repeated, we may have forgotten all about it, and 
it is just as likely as not that w r e do not succeed a second time in giv- 
ing such prompt relief. 

For this and other reasons, it is advantageous to keep a record, or 
case book. This may be a book with printed examination formulae, or 



EXTEMPORANEOUS PRESCRIPTIONS. 177 

simply a blank book, in which we make the necessary memoranda of 
symptoms and treatment. 

If we have such a case book, it is a history of our therapeutical ex- 
perience ; a record of our cases, which will enable us to learn and 
profit from our successes as well as from our failures; it will aid us 
in taking a prominent rank in our profession; to be welcome mem- 
bers and speakers in our societies; or, perhaps, instructive and re- 
spected teachers in our institutions of learning. 

— ^ O £~- 

ABRACADAB R A 

ABRACADABR 

ABRACADAB 

ABRAC AD A 

AB RAC A D 

A B R A C A 

ABRAC 

A B R A 

AB R 

A B 

A 

A cabalistic word-charm anciently used as an incan- 
tation or conjuration; it was also engraved on medals, 
when is was supposed to guard the wearer against 
diseases and evils of all kinds. The word is said to be 
from Ab, Ben, Ruach, Acadosch, Hebrew for Father, 
Son and Holy Ghost. The word Abracadabra was 
arranged in various ways, of which the above, in the 
form of the sacred feminine triangle, was one of the 
most highly esteemed. 



S3 - 






o 

2 - 

P CD 

£ W 

CD 20 

g. §■• 

CD C# 



5 & 



c+ O 

B 8 

go 



3 

D" 



c 

pr 

CD 
go 



C3 
03 



P - 



go 
P 




PART y. 

HISTORY OF THE PRESCRIPTION. 



We are so often tempted to believe that our ways of doing things 
are not only better but also different than those of times long past, 
that we do not always realize how closely our methods resemble 
those practiced during civilizations which are dead and almost for. 
gotten. 

Progress in all sciences, arts and industries has been slow at first, 
gaining development more rapid as the ages went on. Slowly and 
laboriously mankind has struggled on for thousands of years to 
acquire a knowledge of the fundamental truths of anatomy, physi- 
ology and pathology, but when once known these truths enabled 
each succeeding century to add to them as much or more than 
had been learned in all previous time, and while the ratio of 
increase of knowledge in any one century may not have been 
greater than in any previous century .yet the actual volume of new 
knowledge grew enormously from century to century, just as capi- 
tal invested at compound interest, for a long term of years, grows 
at the same steady ratio, and yet the last year will add more than 
any previous year and vastly more than did the second or third 
year. 

But, just as in invested capital, the original few hundreds or 
thousands of dollars remain part of the accumulated wealth of 
millions, so in science the original truths remain part of all subse- 
quent knowledge, together with many ideas which are not truths, 
but which continue to be believed by the masses centuries after 
they have been disproved and discarded by the thinking men of 
later times. 

Probably the original idea in regard to the nature of diseases is 
and was alike among all primitive people, who believe that a 
demon enters the body and causes sickness. The most primitive 
effort to cure was, therefore, naturally a sort of fetichism, exor- 
cisms of the evil spirit, or incantations of good ones to invoke their 
aid in expelling and subduing the evil spirits, and thereby to cure 
disease. Such is the practice among savage tribes to-day and such, 
to a great extent, was at one time the practice among all the people 
of Europe. 



180 THE PRESCRIPTION. 

It would be folly to suppose that the " medicine men," or priests, 
who practiced these incantations did so with a knowledge of their 
uselessness, or without any belief in their efficacy. We would 
credit these men with knowledge so advanced beyond that of their 
contemporaries that it is impossible to believe such difference to 
have existed. We must rather conclude that while some may have 
knowingly practiced imposition, yet in the main the superstitions 
of an age were shared in alike by priests and laymen, and that, if 
any class of persons in a community is more superstitious and 
credulous than another class, it is the class of priests whose object 
in life is an effort to foster blind, unquestioning faith in themselves 
and others. 

We cannot for a moment doubt the honesty of intention or of 
belief on the part of so many of the leading minds in Europe and 
in this country, who in the sixteenth, seventeenth and eighteenth 
centuries professed a belief in witchcraft, and who countenanced 
and encouraged the trial of reputed witches by torture, and who 
seotenced them to death by lire. And just as these minds, noble in 
many regards and enlightened in many matters beyond the age in 
which they lived, jurists and theologians whose reputations have 
come down to us as of wise men of their generation, could, never- 
theless, believe the common superstitions of their times, so we must 
assume that superstitions practiced by physicians of former times, 
and traces of which continue in use to this day, were believed in 
by the physicians themselves, as well as by the people. 

When the physician and the priest was combined in one person, 
and incantations and superstitious rites formed the bulk of the 
medical treatment, that god who heard the most prayers or at 
whose temples most cures were effected, became the particular 
patron of medicine and was worshiped by the people. The priests 
naturally added to their superstitious rites the use of such material 
remedies of which they had any knowledge. 

Naturally, also, when accident, study or common sense had sug- 
gested some successful method of treating an injury or disease, it 
became advisable to record the treatment for future reference, and 
thus, probably, the first prescriptions were engraved on the walls 
of the temples or on pillars (often of phallic significance) in the 
temple grounds, or on votive tablets representing the part of the 
body healed, which were preserved in the temples for the benefit 
of future generations. 

The oldest medical records of which we have any knowledge are 
those of the Egyptians, who ascribed six medical books to their 
moon-god, Thoth, Thoti or Tet (the Greek god Hermes), who was 
the Egyptian god of letters and was ordinarily represented with 



HISTORY OF THK PRESCRIPTION. 181 

the head of an ibis and carrying a tablet and a reed pen in his 
hands, but sometimes also with the uas, f ( the masculine 



r 



sceptre symbolizing the phallus or male organs of generation). 
Among his titles were "lord of truth," "the great god," "the 
chief in the path of the dead," " the self -created, never-born," 
and "the scribe of the truth." Rawlinson says that it was "his 
special office to be present in Amenti when souls were judged, 
to see their deeds weighed in the balance, and to record the 
result. He is also in this world the revealer of God's will. It 
is he who composes the 'Ritual of the Dead,' or at any rate its 
more important portions. It is also he who, in the realms below, 
writes for the good souls, with his own fingers, the 'Book of Res- 
pirations' which protects them, sustains them, gives them life, 
causes them to ' breathe with the souls of the gods forever and 
ever.'" 

To this god the Egyptians ascribed forty-two books, six of which 
were on medical subjects, anatomy, practice of medicine, eye dis- 
eases, womens' diseases, surgical appliances £nd materia medica, 
but some authors ascribed to Thoth a much larger number of 
books; Seleucus, for instance, 20,000 and Manetho even 35,525. In 
the winter of 1872-73, Ebers, the German Egyptologist, obtained 
from an Arab a well-preserved papyrus which had been found four- 
teen years previously among the bones of a mummy, near Thebes. 
This papyrus, from its contents, is judged to be one of the original 
six works on medicine mentioned above, and we learn from it that 
the prescription was already used in its present form at least 1550 
years before Christ. It is yellowish-brown, the letters of the titles 
and quantities being red, of the ingredients and directions, black ; 
its length is sixty feet, and it contains a great number of formulas 
for medicines, salves, etc., for many diseases. Its age was deter- 
mined by a calendar in the work itself and by the names of kings, 
and was fixed by Ebers at 1552, B. C, or at a time when Moses was 
about twenty-one years of age. This work was written in ancient 
Hieratic characters, which were read from right to left, and which 
had about the same relation to Hieroglyphic characters that our 
written script has to our printed letters.* 

It appears from the writings of Herodotus that the physicians of 
Egypt were considered the most learned in the world, and that 
*See Frontispiece and the translation of the same, on page 178. 



182 THE PRESCRIPTION. 

they practiced specialties, being divided into oculists, dentists, 
surgeons, accoucheurs (mostly women, but also men), etc. From 
the researches of Ebers we learn that the physicians wrote pre- 
scriptions which were compounded by a special class of medical 
men who were practically apothecaries or dispensing pharmacists, 
and Kawlinson says that all physicians were separate, as a class, 
from the priests. 

These physicians had to memorize the six medical books of Thoth, 
and if they followed closely the precepts contained therein and the 
patient died, they were held blameless; but if it was found that a phy- 
sician departed in his practice from the prescribed rules, he was put 
to death, no matter what the result of his treatment might have 
been. Nevertheless, Egyptian practice was already far advanced 
and specialized, and their materia medica contained compound 
remedies, such as the "Nepenthes," which is also mentioned in 
the Odissey, and many of the remedies which we employ to-day 
were already in use long before the times of Rameses, Menephtha 
or Moses. 

Centuries before our own era Egyptian medical knowledge had 
spread throughout the then known world, and from Greece and 
Asiatic countries men came to Alexandria to learn the art of the 
physician and then to return to their own country to practice this 
art. Egyptian methods of practice, therefore, probably prevailed 
among all the civilized people of those days. 

We find some collateral evidence of the existence of two distinct 
branches of medical men, physicians and druggists, in the book of 
Ecclesiasticus, or The Wisdom of Jesus, the Son of Sirach, 
in the Bible, where Jesus says : 

" Honour a physician with the honour due unto him for the uses which 
ye may have of him, for the Lord hath created him. 

" For of the Most High cometh healing, and he shall receive honour of the 
king. 

" The skill of the physician shall lift up his head ; and in the sight of great 
men he shall he in admiration. 

"The Lord hath created medicines out of the earth; and he that is wise 
will not abhor them. * * * * 

"Of such doth the apothecary make a confection, and of his works there 
is no end; and from him is peace all over the earth." 

The exact date at which this book was written is not known, but 
it was written about the time of the books of the later prophets of 
the Old Testament, and Jesus, the Son of Sirach, probably lived 
about the time of Haggai and Zechariah, or about 500 or 525 B. C. 
This would make the book about contemporaneous with the close 
of the 26th and last Egyptian Dynasty. During this dynasty (B. C. 
650-527), as well as during some of the previous dynasties (even as 
early as the 19th dynasty, during which the exodus occurred), the 



HISTORY OF THE PRESCRIPTION. 183 

Egyptians frequently came in contact with the Assyrians and 
other Asiatic people, as well as with the Hebrews, both in the 
peaceful pursuits of trade and in war; so that it is probable that 
the Egyptian method of practicing medicine was known and pre- 
vailed through all these lands, and that prescriptions were written 
by one class of practitioners and dispensed by others wherever 
Egyptian science had penetrated. 

Another very early record of prescriptions was found in Cunei- 
form inscriptions, and one of these ancient formulas tells how to 
prepare a remedy for a "diseased gall-bladder which devours the 
top of a man's heart." 

Among the Greeks Chiron was reputed one of the most learned 
among the founders of the science of medicine, and among his 
pupils were Achilles, Jason, iEsculapius, Peleus, Odysseus and 
others. In these earliest Greek times it does not appear to have 
been the habit of the physicians to prescribe and for others to com- 
pound or dispense. JEsculapius used simple herb-remedies, pray- 
ers and incantations, and as these latter often took the form of a 
song or poem, they were called "carmen." This incantation re- 
mained a prominent part of the treatment until quite recent times, 
if, indeed, we must not confess that the carmen still survives in the 
form of songs and prayers practiced at the present time. 

When an effective treatment was discovered the prescription was 
engraved on the door-posts or on the pillars of the temples of JEs- 
culapius. The latter, it will be remembered, was not a person, but a 
secret society which existed for many hundred years, and prescrip- 
tions were handed down from generation to generation to mem- 
bers who were oath-bound not to reveal them to the general 
public. 

In Rome, among the earliest of prescriptions were those of the 
Sybilline books of oracles, the directions in which were, however, 
of a mystic nature and not like our prescriptions of to-day. But 
there were already many prescriptions which were known not 
only to the priests and ^Esculapeans, but also to the general pub- 
lic, and among others the Censor Cato is mentioned as having pos- 
sessed an old prescripton book, the directions of which he followed 
in treating himself and his friends. These ancient Greek prescrip- 
tions were of a curious character, according to our present ideas. 
For instance, they directed that no medicine should be adminis- 
tered to a sick cow by a woman; they lauded cabbage as a cure 
for almost every ill ; placed great stress on the figure 3 and sup- 
posed medicines to be more active when three drams, three 
ounces or three times any quantity was given, and they at the 



184 THE PRESCRIPTION. 

same time directed the repetition of cabalistic words and incanta- 
tions. 

Some of the remedies were, however, of value, as, for instance, 
when Hercdikus directed consumptives to drink the milk direct 
from the breasts of women. This physician is one of the earliest 
of whom it is recorded that he charged a fee for his advice and pre- 
scriptions. 

From one of the Hippocratic books it appears that the Greek 
physicians generally prepared their own remedies, which were ad- 
ministered by their pupils, who remained with the sick and watcheci 
and reported on the symptoms. There were, therefore, at that 
early time few, if any, prescriptions in the modern sense of the 
word, although there was a separate class of root diggers (rhizo- 
tomes) who gathered and prepared the medicinal plants, often ac- 
companying the preparation by mystic and superstitious rites. 
Sometimes the rhizotomes prepared compound remedies, and were 
then called pharmacopoles, among whom are enumerated Thra- 
syas, Alexias, Aristophilus and Aristotle. 

The pharmacy of these times was very crude, and even the pre- 
scriptions for compound remedies were crude and comparatively 
simple. 

But after the Greeks had come into closer contact with Egyp- 
tian civilization and customs, or during the period of the highest 
achievements and reputation of the Alexandrian school under the 
Ptolemies (about 300 B. C), there was a practice of medicine more 
nearly like our own. Herophilus, for instance, was a friend of 
more complicated prescriptions, and taught that whenever the 
causes of diseases were complicated the remedies should be corre- 
spondingly compound. The profession of medicine became di- 
vided into physicians proper, surgeons and rhizotomes or pharma- 
copoles, the latter being more nearly like the druggists of our own 
times. The physicians seem to have been very self-conceited and 
to have had an exalted opinion of their own importance, for they 
thought it beneath their dignity to do any manual work, and so 
they left operations to the surgeons and the compounding and dis- 
pensing of medicines to the pharmacopoles, both of which classes 
the physicians considered as beneath themselves and as their ser- 
vants. As Kurt Sprengel naively says: "Since this time the drug- 
gists were the hand- servants of the physicians." Necessarily, such 
a method of practice demanded that the physicians should write 
their directions for the guidance of the pharmacopoles in com- 
pounding the medicines, and, undoubtedly, in the main, these 
took the form of the prescriptions as used to-day. 



1 



HISTORY OF THE PRESCRIPTION. 185 

Celsus records that this division of labor, or specialization, was 
of the greatest benefit to surgery. At this time, there were physi- 
cians whose names came to our own times only in connection with 
the names of remedies which they had originated and with which 
their names became identified. The prescriptions for some of 
these preparations were quite complicated, the celebrated Theriac 
of Mithridates, for instance, containing fifty-four ingredients. 

We have already learnt that from earliest times the public, as 
well as the physicians themselves, had great faith in incantations 
and invocations of the gods. But in the Oriental nations these be- 
liefs reached their most extravagant development during the last 
century before Christ and during the earliest centuries of the 
Christian era, and the physicians of all the then known countries 
were addicted to these practices. We must remember that these 
times are even now supposed by many to have been peculiarly richin 
miraculous events, and many of the reputed miracles of that time 
are believed by those who would not under any circumstances give 
credence to miracles claimed to have occurred in more recent 
times. Human credulity and superstition among the Oriental na- 
tions, Jewish as well as Heathen, ran riot about the time of the 
beginning of the Christian era, and this had its effect on the prac- 
tice of medicine as well as on the prescription itself. After the 
birth of Christ, Christian and Jewish writers tried to out-do each 
other in their superstitious vagaries, and science was not only re- 
tarded but set back many centuries in its course, and the effect 
was that eventually all human energies stagnated during a long 
period of time, commonly referred to as the "dark ages." Pagan, 
Jewish and Christian physicians and theologians vied with each 
other to invent fantastic theories, for which they claimed the faith 
of the public. Barbaric words, phallic symbols or the names of 
their gods were used by Pagan physicians in preparing their medi- 
cines or in writing their prescriptions, and when we study the his- 
tory of these times we are compelled to believe that the physicians 
did not practice these superstitions from a desire to deceive the 
public, but because they believed in them themselves. There were 
here and there men like Possidonius and Philagrius among the 
Greeks (about A. D. 100) or Galen (about A. D. 150) who declared 
against these superstitions, but the age was one in which their 
voices were unheeded and without effect. 

Theosophic vagaries and sophistries took the place of common 
sense, and no proposition was so absurd that it did not find be- 
lievers. In fact, the very grotesqueness and improbability of some 
of these propositions seemed to recommend them all the more to 
the faith of the believers. 



186 THE PRESCRIPTION. 

A school of philosophers was founded which considered the 
study and allegorical explanation of the Holy Writings to be the 
chief end in life. Belief in magic and the study of demonology 
became prevalent, and Apollonius of Tyana (about A. D. 96) in- 
vented the talismans, which consisted of medals with mystic, holy 
or barbaric words or signs, and which worked cures of all diseases, 
just as their descendants, the amulets of the church, are by many 
believed to do to-day. The theory of demoniac influence as the 
cause of disease became again a common belief, and exorcisms 
took the place of rational treatment. Certain names of Chaldaic, 
Persian, Phoenician or Hebrew origin were supposed to be particu- 
larly effective in the conjuration of evil spirits, and "Saboath" and 
"Adonai" were thought to be among the most powerful of these 
words. Jamblichus (about A. D. 307) said that especially those 
words which had no meaning to the human mind were the most 
powerful in their effects on the infernal beings. Galen, who was 
opposed to all this superstition of his times, says that many physi- 
cians thought medicines to lose much, if not all, of their potency if 
they were not prescribed by their Babylonian or Egyptian names. 
Certain mystic poems recited by the physicians over the sick were 
credited with powerful healing influences, or the physicians wrote 
such verses on paper instead of a regular prescription, and these 
mystic prescriptions were either carried as charms or were rolled 
into pellets and swallowed as a remedy by the patient. 

Among the Pagans, certain symbolic (phallic) signs or represen- 
tations of the genital organs were used, or the symbols which rep- 
resented their gods: If for Jupiter, J|| for Mercury, C3 for 

Venus, etc. Among Roman matrons and maidens jewels or charms 
in the shape of the phallus or masculine generative organs or tri- 
nity were worn as amulets to ward off evil and sickness, while 
among the Christians the symbol of the cross (also of phallic origin 
and significance) was thought to be particularly efficacious. Chry- 
sostomos preached that the cross, carried as a charm, could open 
locked doors, could counteract the poisonous effects of hemlock 
(conium), and render the bites of venomous and rabid animals 
harmless, and it was even believed that it could raise the dead, and 
many resurrections from the dead were ascribed to the bishops of 
the early Christian churches. The bones and ashes of martyrs, 
holy shrines (Pagan as well as Christian), pilgrimages, etc., 
worked wonderful cures. Prayers, the laying on of hands, an- 
ointing with oil, and other superstitious practices, were credited 
with more medicinal virtue than the material remedies. 



THE PRESCRIPTION. 187 

The figure ^ J or INUI was engraved on amulets and was 

considered of great virtue. The words "Saboath," "Adonai," 
"Amen,*" etc., were used frequently as charms. Alexander recom- 
mended a barbaric formula against pestilence. Basilides (about 
A. D. 117) propounded a theory that from the Eternal Father came 
Nus; this was Christ, who begat Logos; from Logos came Phrone" 
sis, and the latter produced Sophia and Dynamis, from whom 
sprang 365 angels, who then built heaven. The names of these 
angels were used in conjuration for producing great results. The 
name of Christ is "ABRAXAS, 1 ' which esoteric, mystic name was 
explained to include in itself the number 365 and to be the noblest 
emanation from God. 

The pupils of Basilides then invented the Abraxas medals, carved 
gems or talismans, with the figure of a man with the head of a 
cock and the legs like serpents, with a whip in his hand, and w r ith 
some mystic word, such as "Jao," "Jaldaboth," ''Adonai," "Sa- 

O O 
baoth," "Eloah" or "Or." Also with the figure 9%A or 

O O 

These medals were considered most powerful charms for prevent- 
ing and curing diseases. 

Even the Christians adopted laying-on of hands, anointing, etc. 
While among the Christians the sign of the cross was considered 
to be of particular virtue, the Greeks and Romans used the signs 

of the gods, If JJt and ^D the latter sign representing Venus, 

being a modification of the Egyptian "ankh," Aj* the "symbol of 

*The word "Ainen," which even now is used by all Christian people at the 
close of their prayers, was formerly also used as an opening invocation in 
church services, last wills and testaments, etc. It is now generally ex- 
plained to mean " So let it be ! " but it was originally an invocation of the 
Egyptian deity, Amnion. According to Rawlinson, Ammon was the great 
god of Thebes, the southern Egyptian capital ; among his titles were : "Lord 
of Heaven," "Eldest of the Gods," etc. Ammon was ordinarily invoked as 
"Amen" or Amen-Ra," an invocation meaning "Chief," "King of the Gods," 
or "Lord of all Earthly Thrones." The syllables "Amen" occur in quite a 
number of names of priests, etc., as part of them. 

This invocation, therefore, appeals to the most powerful god to hear the 
prayer, and as Ammon's disposition to hear and answer prayers, and his 
ability to grant the request, seem never to have been questioned, we can 
readily understand how in the course of time this old Egyptian invocation 
came to mean "So let it be ! " and how the word came to be considered such 
a powerful charm in compelling good and bad supernatural powers to 
work the will of him who used the invocation. 



188 HISTORY OF THE PRESCRIFi ION. 

life," so commonly represented as carried in the hands of the 
Egyptian deities, and which later on became the "crux ansata" 
of the Christian Church, and which symbolized sexual congress. 
And to these symbols, used alone, or as invocations or charms on 
prescriptions for material remedies, were ascribed the same wonder- 
ful effects that to-day are supposed to be exercised by relics of saints 
and martyrs, pieces of the true cross, blessed medals and amulets, 
and by four leaved clover or the horse-shoe (a yonic charm or a 
modified representation of the ecclesiastical u door of life" or the 
external female organs of generation) for good luck, madstones 
for rabies, buckeyes for rheumatism and potatoes for Bright' s dis- 
ease. 

Four hundred years after Christ, Marcellus of Bordeaux recom- 
mended the removal of a foreign body from the eye by touching 
the eye and repeating three times: "Tetune resonco bregangresso^ 
spitting after each repetition; to draw an impacted substance from 
the oesophagus, by sayiug three times nine times: "Os gorgonis 
basio" ; to cure colic, by engraving the following on gold medals 
and carrying the amulet in the pocket: 



L * 


M 





R 


J A 


L * 


M 


© 


R 


J A 


L * 


M 


© 


R 


J A 



Remedies were most active when compounded on Thursdays; 
Rhamnus spina Christi was a valuable remedy because Christ was 
crowned with thorns. In croup, accompanied by inflamed uvula, 
a grape or raisin was given (on account of the similarity of the 
name uva to uvula), and the physician repeated three times: "Uva 
uvam emendaV; when a patient had a felon on his finger he had 
to touch a wall and recite the following carmen three times: "Pw, 
pu y pu; nunquam ego te vicleam per parietem repere' ' ; patients had 
to stand or lie facing the east while taking medicine. 

About this time other remedies were used, such as hanging a 
rabbit's heart about the neck to cure intermittent fevers; boiling 
and eating a new born puppy to prevent colic for the balance of 
one's life; while, according to some authors, talismans and amu- 
lets were active only when prepared during a waning moon. 

These superstitions went so far that, as is related, the physicians 
of the Emperor Cbnstantin recommended that he should bathe 
daily in the blood of freshly killed infants in order that he might 
cure himself of a serious sickness; but it is also related that the 



THE PRESCRIPTION. 189 

Apostle St. Paul appeared to Const aDtin in his dream and warned 
him not to use this remedy, and in consequence of this dream Con- 
stantin was converted to Christianity. 

Aetius (A. D. 545) gave a formula for a certain salve, the ingre- 
dients of which were to be melted together and then stirred until 
the salve was done, while the druggist kept repeating the incan- 
tation: "The god of Abraham, Isaac and Jacob render this remedy 
active!" He recommended that when a bone was swallowed the 
patient should repeat the carmen: "Even as Christ rescued Lazarus 
from the grave and Jonah from the whale, so come thou forth, oh, 
bone!" or, "The martyr Blasius and the servant of Christ com- 
mand thee come out or pass down." 

Alexander of Tralles (A. D. 543) cured colic by an iron ring on 
which was engraved the symbol of the gnostics, two interlaced 




triangles, Jj[ j^ symbolizing sexual congress, a symbol which 

somewhat modified by the symbol or sign of Venus, ^fi, being 

placed in the center, and surrounded by a snake, bent into a circle 
and with its tail in its mouth emblematical of sexual passion or 
eternity, forms the seal of the Theosophic societies in St. Louis. Or 
he used an amulet consisting of an olive leaf, on which he wrote 
with ink "KA.POI.A." 

Gradually, Grecian mythology, with its phallic symbology im- 
ported from Egypt and India, yielded to Christianity and disap- 
peared. Jehovah had conquered Jupiter and displaced him; in- 
vocations were addressed most commonly to Jesus Christ; the vir- 
gin Mary (Ma-r-ia, "mother of god") had taken the place of Hygeia, 
or of the Indian goddess "Maya," wife of Brahma, "the mother of 
the gods/' or of the Egyptian goddess 44 Ma" (''mother of the gods"), 
the Greek goddess * 'Mai -a" (-mother of the gods"), the Spanish' 
"Maya," the French "Maye," the English "May-Queen." The 
saints. Cosmos and Damian, had taken the place of ^Esculapius in 
public estimation, and all traces of the heathen practices and in- 
vocations had disappeared from the prescription, except the little 



stroke in 



jh, the reminder of the once powerful Jupiter, \j 



*In a review of the first edition of this book, a pharmaceutical journal 
ridiculed the idea that the stroke in fj was really a relic of a super- 



4 



190 HISTORY OF THE PRESCRIPTION. 

It wouiu ioc*u too far and scarcely be pertinent to the History of 
the Prescription to consider the superstitions associated with as- 
trology and alchemy, except, perhaps, to remind of the many 
formulas for the preparation of the "elixir of life,"- which was to 
allow man to live forever and to be forever young. 

A practice also connected with astrology and alchemy, and which 
had great influence on the form of the prescription, consisted in 
substituting various signs for the names of materials, apparatuses 
and processes used in constructing formulas and in the directions 
for compounding them. A complete list of these signs was pub- 
lished in 1783 in a German book entitled "Medicinisch-Chymiscli 

stitious invocation of Jupiter, and said that it was a fantastic notion of Dr. 
Paris, published in his"Pharrnacologia." That this is not so, and that the 



4 



symbol if has long been associated with Jupiter, appears from the 



"Mediciniseh-Chymisch und Alcheraistiches Oraculum," published in 17^3, 
to which reference will be made again, and in which "Recipe" is repre- 
sented as shown in the table of signs. One of these signs is clearly the 
sign for Jupiter, while another is but a slight modification of it. Farther 
evidence is, however, to be obtained by an examination of the symbols 
for tin, Stannum, called in alchemistic works "Jupiter." I copy only a few 



of the symbols for Jupiter, as follows: H* £JU |"T One of 

these symbols is the letter R, and it proves that the letter R and the sym- 
bols £g and If were interchangeable and synonymous at one 



time, and all meant "Jupiter." 

It must be further considered that this book was printed before Dr. Paris- 
wrote, and that the author of it claims to have gathered his information 
from a book published in tne year 1549 and from a manuscript of the year 

1300. There can be no reasonable doubt, therefore, that Jf originally 



Jl 



meant an invocation to Jupiter, and only in later times was interpreted as 
"Recipe." 

It has been recently suggested to use the Greek letter Delta, a pyramidal 

triangle, /A , as a sign for the drachm. It will be noticed, by 

reference to the table of alchemistic symbols from the "Oraculum," that 
a similar sign was used several hundred years ago. 



THE PRESCRIPTION. 191 

und Alchemistiches Oraculum, oder Clavis Sapiential" ("Medico. 
Chemical and Alchemistic Oracle, or Key to Wisdom"), which is 
claimed by the author to be based on a work of the year 1549 and 
on a manuscript of the year 1300. A few of these signs are repro- 
duced to give an idea of their nature: 

Alchemistic Symbols. 






Albumen . . . 

Alcohol 

Alkali 

Alum 

Arsenic 

Borax 

Camphor && , 000< # OOOQO; 

Drachm J . ^SV» 

«- ojzM&M&At. 

Honey 

Iron 




As corroborative of the suggestion made on page 49, that the ounce sign, 
^£* , is merely the drachm sign, ^t , with an extra hook added to 



designate the next higher denomination, I call attention to the double 
drachm sign, ^ ^ , used as a sign for the ounce in the same work. 

It is also curious to note that the scruple sign, 'feB * which we use- 



^ 



102 HISTOl'.Y < F THE PRESCRIPTION. 

Lead J^,l\J^,^!tt,Qy,T+*y,%, 

m««„ t ■t%4rWM#&®WS*i 

«» ^4Fj«S.<8f / ©,N»^'P, 

Oliveoil 50,lA,O0,T\s 

Ou.ce I,»,33,'5P^r^, 

Recipe </&,•&,'%»**{* /jf' 

Scruple \«^ t^TT, 

sp« <&.o..^.^^ *aMr 

$,0,°E«fc*, *>, $, *,£«?, 

»»*■■■ i.VVfl/J.aySCA, 

When a prescription was written and the physician desired to 
designate any of the substances for which these signs were in- 
vented he would use such a sign instead of the name of the prepa- 
ration, and the effect on the appearance of the prescription may 
be readily imagined, and it is evident that the physician succeeded 
perfectly in making his preparation a mystery to the patient. 

This method of prescribing continued to be used in some parts 
of Europe until quite recent times, and I am acquainted with phar- 
macists who, in their apprentice years, had personal experience 

to-day, was apparantly not in use in Germany in 1755, for it is not given In 
the list of signs in the " Oraculum." It is quoted as a sign for •* burnt 

copper" or "crocus veneris, 3 ' <M J is given as the only sign for -" Obulus 

scrupulus semis," a half scruple or ten grains. One of the scruple signs is a 
half circle without the small horizontal stroke. 



HISTORY OF THE PRESCRIPTION. 193 

in compounding prescriptions in which some of tnc ingredients 
were designated by some of these signs. 

The origin of these signs is sometimes quite curious. Thus, the 
symbol for vinegar {"vinum mortuum" or dead wine) is a cross, 

*4^, because the Roman soldiers offered vinegar on a sponge to 

the crucified Christ. 

As all our customs, arts, religions, philosophies, sciences, etc., 
bear traces of the influence of the phallic worships of former days, 
so also do alchemy and astrology abound with references to phal- 
lic ideas and symbols. 



6 



Gold is represented by various signs, of which /^S asserts 

the supremacy of the masculine principle in nature. The sign 
C^Jj is evidently the old Egyptian yC_Jj vei T slightly 
changed, and shows the male and female principles in conjuga- 
tion. The sign for "calcinatio aim," «JoC » (burning gold 



to ashes or powder, an art now lost), is a very mystic and esoteric 
symbol, representing four phalli, or masculine organs, meeting in 
one common yoni, or feminine cleft, and resembles the symbol for 
the "Four Great Gods" of the Phoenicians, which is also the origin 
of the Maltese Cross. 

The sign for copper (Venus) is U, a modification of the Egyp- 
tian ankh, Jj* and asserts the greater importance of the fem- 
inine attributes; the sign for antimony, pt , asserts the supre- 
macy of the male principle in nature. 

Mercury is represented by the caduceus, a phallic rod with tne 
serpents (symbols for sexual passion) twined about it; or, in one of the 

signs, Qj It , by a symbolic representation of a linga-in- 

yoni, an erect male organ inserted in the female cleft. 



J94 THE PRESCRIPTION. 

A metal king, "regulus," the little globule of metal reduced by 
the blowpipe, was represented by a crown, \*l » wnic k 

was placed on the sign of the metal. Thus, antimony being pK 

the sign for "antimonii regulus" was ^F . 

The elements ("elementa" or "principia corporum" — at that time 
air, earth, fire andw r ater) were expressed by the sign of the gnos- 
tics, xX > signifying sexual embrace, it being believed that all 
compounds were the result of sexual union of the elements. The 

phallic shape of the symbol QO ""T^ * or a ^receptaciilum" is 

plain enough, though the application seems obscure. 

The book referred to contains 1,852 symbols for 252 different 
articles, of which a very large proportion show traces of phallic 
meaning. 

It is not necessary to more than remind of that other aberration 
of the human mind, when it was supposed that for every human 
ailment some remedy might be found among human or animal 
excrements. Probably to this time must be traced the origin of 
the use of human urine as a remedy for internal use, as often prac- 
ticed among the lower classes to this day. 

It seems that when the human mind had exhausted the depths 
of superstition it naturally ran to filth. A reaction had to come! 
For nearly a thousand years these degrading superstitions had 
controlled the practice of medicine, and during all these centuries 
there are but few real physicians mentioned as having lived in the 
Oriental countries, and none of note as having lived among the 
Occidental European people, and it is not until about the seventh 
or eighth centuries of our era that we find again records of ra- 
tional medical practice in various countries. 

Prescriptions in our present sense, orders for active medicinal 
agents, must have been few and far between during these "dark 
ages." It is true that these superstitions did not vanish at once 



HISTORY OF THE PRESCRIPTION. 195 

ior entirely, for many of them survive to this clay. Saints and 
martyrs, crosses and amulets, pilgrimages and shrines, laying on 
of hands and anointing are still considered of value among Chris- 
tians, as well as among Heathens. The madstone and the buckeye, 
the four-leaved clover and the divining rod still have their devotees. 
The "Christian Science People" and the "Faith-Curers" would 
again substitute prayers and incantations for rational medicine 
and hygiene. Among Mohammedans, verses from the Koran are 
still written on paper and carried as charms, or rolled into pellets 
and swallowed as prophylactics or as cures; or they write verses 
on leaves and macerate these leaves in water, which then becomes 
as valuable and powerful medicine, as, for instance, the Homoeo- 
pathic Dilutions. Not many years ago a writer in a prominent 
newspaper of St. Louis, Mo., recommended as a positive cure for 
the bite of a rabid or venomous animal a formula, consisting of a 
string of senseless letters, which were to be written on a piece of 
•paper and swallowed, and a dozen or more citizens, giving their 
names and addresses, testified to the efficacy of the charm. This 
formula, the writer said, was an heirloom in his family, having 
been given to his great-grandfather or grandfather by a priest out 
of gratitude for some kindness done the latter. 

The so-called * 'sympathetic remedies" are well known: The re- 
moval of a wart by rubbing it with a newly drawn tooth and then 
burying the tooth; curing the bite of a dog by laying on it a few of 
the hairs of the dog ; and the belief that if ever the dog becomes 
mad in the future the bitten person will also do so; and the fre- 
quent demand to have a dog that has bitten a person killed is a 
remnant of the same superstition. The belief in the influence of the 
moon on matters of common occurrence (related to the worship of 
the Virgin) is still widespread, for many people imagine that if they 
sleep where the light of the moon falls upon them they will become 
lunatics (the very term referring to the moon) or somnambulists; 
that the ripening of fruits and vegetables is influenced beneficially 
or otherwise by the full moon, the beliefs in this regard not agree- 
ing—that the cutting of the hair should not be done during the 
increasing moon, according to some barbers, or not during the de- 
creasing moon, according to others; that vegetables or plants, the 
edible portion of which grows above ground, should be planted 
during the waxing moon, while those whose edible portions grow 
underground should be planted during the waning moon; or that 
grapes and other vines should be pruned and hens put to hatch 
just after the full moon, etc. 

The believers in the mysterious powers of a seventh son of a 
seventh son, and in the advice and prophecies of such works as 



196 THE PKESCRIPTIOX. 

Zadkiel's Astrological Almanac may be counted by thousands, if 
not by millions, and fortune-tellers still do a thriving business in 
prophecies and sale of charms; "weather prophets" make an easy 
living; gamblers and betting men generally put their faith in mas- 
cots, and the belief in lucky and unlucky days or numbers is all 
but universal . 

We have learned that the prescription was used in the same 
manner as it is among us to-day at least 1550 years before Christ, 
and among the Greeks at least 300 years before the beginning of 
the Christian era. A study of the history of medicine entitles us 
to the conclusion that, ever since those remote times, there have 
always been physicians who only prescribed and pharmacists who 
only dispensed, although they may have been very few during a 
long time, and also, that at all times, just as now, there have been 
numerous other physicians who dispensed their own remedies, 
and thus combined both professions in one person. 

Our positive knowledge on the renaissance of the prescription 
among those nations whom we consider as the sources of our 
customs, dates back for more than a thousand years; for, as we 
have learned above, it is altogether probable that the use of ra- 
tional prescriptions and of carefully compounded rational medi" 
cines was exceedingly uncommon among the European nations 
generally during the earlier centuries of the Christian era. But it 
seems that many of the old doctrines and customs of the Alexan- 
drian school had been kept alive by the Arabs, who used a more 
rational system of treatment and less superstitious practices than 
the other people mentioned, and from this source scientific medi- 
cine again found its way to the Occidental countries. This does 
not mean that Arabian medical science was of a very advanced 
order, for it was not, but that the Arabs had preserved the right 
spirit and a desire to study and observe rationally. Just how 
early the Saracens made their influence felt is uncertain, some 
authors stating that a university at Dschondisabur was established 
during the time of the Emperor Aurelian (about 270 A. D.), or 
nearly fifty years before the conversion of the Emperor Constantine 
in the year 323. Serious doubts are, however, entertained by other 
authors in regard to this statement, and it is, perhaps, safer to be- 
gin with more firmly established facts. It is certain that soon 
after the year 600 A. D. reference to this university is met with 
frequently, and that it enjoyed a great reputation, especially as a 
centre for medical learning. About 750 years after Christ, Bagdad 
became an important university city, as many as 6,000 students 
being present at a time from all parts of the world. Here were 
established hospitals for clinical instruction and public drug stores 



HISTORY OF THE PRESCRIPTION, 197 

at which students of pharmacy received instruction in their art; 
and this university retained its eminence until the thirteenth century . 

The Arabs had meanwhile overrun and subjugated many coun- 
tries in Southern Europe, and especially Spain owed the period of 
its highest prosperity to the rule of the Saracens or Moors. The 
university at Cordova was the most celebrated in the world for 
several centuries, and contained a library of 250,000 volumes. In 
Sevilla, Toledo and Murcia in Spain were other universities 
scarcely less celebrated. 

That which interests us most here is the fact that, at a time when 
Occidental Christian Europe had sunken into a mental lethargy, 
these Mohammedan seats of learning kept alive the old Egyptian 
and Greek methods of medical treatment, and that there were 
both physicians who prescribed and apothecaries who dispensed. 
Another matter of interest is the prominence given to pharmacy. 
The study of medicine was hindered by the belief that the soul of 
the dead did not leave the body at death, but gradually withdrew 
itself from the extremities to the chest, where it remained for some 
time. To make a dissection was therefore to torture the soul. 
Then, when the dead were buried in their tombs, they were visited 
by two angels, Nak-hir and Monker, who judged them. During 
this examination, the body had to stand erect and be perfect with 
no parts missing; therefore, religious prejudice and opinion made 
post-mortems or dissections impossible. But, as if to make up for 
this drawback, the Arabs placed correspondingly greater stress 
on the study of materia medica and pharmacy, the latter and al- 
chemy being the favorite studies. The prevalence of such Arabian 
words as alcohol, elixir, julep, syrup, looch, roob, naphtha, cam- 
phor, bezoar, etc., in later pharmaceutical nomenclature attests the 
influence of these Moorish schools on this branch of study. 

The first dispensatory, entitled "Krabadin," was written by 
Sabor ebn Sahel, a director of the university at Dschondisabur, in 
the last half of the ninth century. Another celebrated work was 
the "Krabadin" of Abn'l Hassan, a Christian court physician under 
the Khalif of Bagdad in the twelfth century, which latter work 
became the legal authority on pharmaceutical matters. The 
Arabian drug stores stood under direct control of the government, 
and the quality of medicines, as well as the prices, were regulated 
by commissioners who visited and inspected the drug stores. 
In the eleventh century, the separation of physicians and pharma- 
cists was compulsory in the countries under control of the Moors. 
In this century, the school of Salermo, in Italy, under the control 
of the Arabian faculties, compelled its students to swear not to 
accept percentages from the druggists on their prescriptions. 



198 THE PRESCRIPTION. 

It is certain that drug stores for the dispensing of medicines on 
physicians' prescriptions were already to be found in Cordova 
and other large cities under the control of the Arabs previous to 
the twelfth century, and, as early as 1233, pharmacy laws were al- 
ready passed in the two Sicilies. It is also pretty certain that by this 
time the superstitious aberrations that had characterized the first 
600 or 700 years of the Christian era had dwindled to comparatively 
insignificant proportions in the Christian portions of Europe, and 
that the prescriptions were no longer mere superstitious formulas, 
but directions for compounding material substances of more or 
less valuable medicinal character. 

In England, about the middle of the fourteenth century, the pro- 
fessions of physicians and pharmacists were already separated, as 
appears from Chaucer's "Canterbury Tales," in which Chaucer 
insinuates that physicians demanded percentages on their prescrip- 
tions. 

In Germany, the first drug store mentioned was at Muenster, in 
1267; another, a little later, is mentioned as being at Augsberg. 
In 1568, Hans Saehs wrote in his "True Descriptions of All Pro- 
fessions:" 

"In my shop of drugs are stored 

Many things of sweet accord; 

Spices with sugar I combine, 

Enemas and purges I divine. 

To strengthen the weak and the sickly, 

Refreshing draughts I furnish quickly. 

All these, with utmost care, 

On prescriptions I prepare." 

In England, at this time, a druggist, by the name of Bulleyn, 
wrote of the apothecary: "He is neither to decrease nor diminish 
the physician's prescription . He is to meddle only in his own vo- 
cation, and to remember that his office is only to be the physician's 
cook." 

In France, one clause of an oath, which every apothecary was 
required to take, was to "never administer poisons nor recommend 
their administration/even to our greatest enemies; not to give 
drinks to produce abortion, without the advice of a physician; also 
to execute accurately their prescriptions, without adding or dimin- 
ishing anything contained in them, that they may in every respect 
be prepared 'secundem artem/ ,J 

In 1548, Charles V, at the congress of Augsburg, ordered an an- 
nual inspection of drug stores to control the quality of the medi- 
cines, as it had "come to our ears that deteriorated and spurious 
drugs are being dispensed on physicians' prescriptions." 






HISTORY OF THE PRESCRIPTION. 199 

In Belgium, in the city of Bruges, in 1683, a law was passed for- 
bidding physicians to dispense their own remedies. 

In the seventeenth century, the oath demanded of a German 
drug clerk contained the clause: "That he will not deliberately 
change a physician's prescription. " In this century (1643), Mosche- 
rosch explained the "I£" as follows: ' l The direction on these 
papers are usually preceded by 'Rec,' which, in fact, stands for 
*per decern, and means that one prescription out of ten may help, 
or, more properly speaking, that out of ten patients one may es- 
cape. They are called patients when they get into the hands of 
the fraternity, for from that moment they are condemned to suffer 
all the tortures of the damned," 

Since these times we have an unbroken record of the existence 
of two separate professions of medicine and pharmacy, and while 
at times and certain places physicians may have dispensed their 
own remedies, or druggists may have meddled with the visiting of 
and prescribing for patients, yet, in the main, physicians prescribed 
and pharmacists dispensed, as they do now, for several thousand 
years. In this connection, no account is taken of Chinese practice, 
which is like our own, and probably has been so for several thou- 
sand years, for their practice is so foreign to our own and to the 
civilizations of which we have spoken, that it is improbable that 
Chinese customs had any influence on Egyptian, Greek or modern 
methods of practice. Nor is it likely that Chinese civilization had 
any forming influence on old Egyptian customs, as recent investi- 
gations tend rather to trace the origin of this wonderful people to 
a western origin, perhaps to Yucatan. 

It by no means follows, from what has been said, that the prac" 
tice of physicians prescribing and pharmacists dispensing has 
been or is even now universal. 

In England, for instance, during the last few centuries and well 
into this century, the practitioner of medicine commonly was also 
the proprietor of the "chemist's shop" or drug store. This he usu- 
ally left in charge of his assistant, who "read medicine" with him. 
If he himself prescribed for a patient in his shop, then he probably 
often combined the functions of physician and pharmacist in one 
person and dispensed his own remedies. But if he was called away 
from his shop to visit a patient, and had to send the prescription 
back for his assistant to compound, the fact that the latter was 
not always an expert pharmacist made it necessary for him to 
write out the directions for compounding, or the "prescription", 
much more completely and in detail than would have been neces- 
sary if he could have sent his prescription to a properly qualified 
apothecary. In this manner grew up that astonishing method of 



200 THE PRESCRIPTION. 

prescribing, of which an example is given on page 113, and which 
was perhaps the highest perfection to which the prescription ever 
attained. Even now, the two professions are not as entirely dis- 
tinct in England as they are in some other countries, and it is not un- 
usual to see advertisements in English pharmaceutical journals for 
drug clerks who are experienced in counter-prescribing. 

In our country, probably, the majority of physicians outside of 
the larger cities dispense their own remedies and do not write 
prescriptions, but this is due to the conditions under which they 
exist. Sparsely settled neighborhoods often compel American 
country practitioners to ride many miles to their patients, and it 
would evidently be impracticable to send back to a drug store for 
the medicines, as it would cause too much trouble and delay. 
Many old and good practitioners in this country have, possibly, 
never in their lives written a prescription, and might, perhaps, be 
at a loss to know how to proceed to write one. 

Yet it would be obviously erroneous to say that English or 
American physicians do not write prescriptions because some, or 
perhaps even the greater number, do not do so. We must rather 
conclude that in all European countries, as well as in American 
countries inhabited by the descendants of Europeans, the practice 
of physicians writing prescriptions and sending them to drug 
stores to be compounded has been common for many centuries in 
all localities which are sufficiently densely populated to support 

both professions. 

»- — • — — ^ „ 

APPENDIX. 

Some doubts having been expressed in a review of the second edi- 
tion of this book in one of the pharmaceutical journals, in regard to 
the statement that the little cross-line in ^ is a relic of former super- 
stitious invocations of Jupiter, I thought it of sufficient interest to 
present more fully to the consideration of the readers of this book 
the reasons which have influenced different writers to make such a 
statement. I, therefore, take the following, slightly modified so as 
to omit ail controversial parts, from a letter contributed by me to 
the Chemist and Druggist, London, in the issue of July 25, 1891 : 

In tracing remains of former superstitions in modern customs it is 
not necessary to prove that they are used now with any knowledge 
of the original meaning, or that any traces of the old superstitions 
still survive in any degree whatever. It is important that we should 
realize that the present use of symbols, rites or customs does not 
imply any general knowledge of their origins, as this may have 
been lost in the course of time, and we may continue to use them 



APPENDIX. 201 

without any knowledge of their origins and with new, though often 
related, meanings. 

For instance, in ancient Babylon it was a religious duty of every 
woman to cohabit once in her life with a man other than her hus- 
band, in honor of the goddess Mylitta. When she went to the 
temple for this purpose, she signified it by taking a seat under 
a bough of mistletoe, which plant was sacred to the goddess. A 
man, seeing a woman "under the mistletoe," could then approach 
her, and after giving her money, which she offered on the altar of 
the goddess, he took her to one of the alcoves provided for the 
purpose and there had sexual connection with her. Traces of this 
still exist; one of the modern botanical names of the mistletoe is 
"Mylitta"; but when men now surprise girls or women "under 
the mistletoe" and demand the customary kiss, they do so without a 
knowledge of the origin of the custom, and without a knowledge 
that in ancient times they might have demanded coition. Similarly 
numberless present customs, symbols, ceremonies, rites, etc., may 
be traced back to ancient beliefs and practices, while the public is 
ignorant of such connection between the now and the long ago. 

So it is not necessary to prove that our present Ifc was ever actually 
and knowingly used as an invocation of Jupiter to prove that it 



had its origin in such invocation. Originally, no doubt, 



^ 



was an invocation or conjuration of Jupiter when used on prescrip- 
tions, but it was only one of many forms of charms, conjurations or 
invocations used in this manner, as we are told by historians that 
they were used. There is, furthermore, no doubt whatever that the 
letter R is an abbreviation of "Recipe", but I do not believe that 
the plain letter R was used as an abbreviation for "Recipe" in 
olden times. I think that if anyone attempted to prove from the 
history of medicine or from any written source, that the original 
form of fy was simply the letter R, he would find it impossible. I 
have come across no evidence to show that the plain letter R was 
so used previous to quite recent times, and while I believe that 1^ 
was interpreted as an abbreviation for "Recipe " very early in the 
Christian era, it was formerly not written as a plain R. There is 
evidence, on the contrary, that it was not written as the simple 
letter even so late as the end of the last century. 

I believe that the character R at the head of a prescription is a 
reminder of the former use of the Jupiter symbol as an invocation 
or conjuration; this statement refers to the character or sign 3^, 
not to the plain letter R, although in a remote way it may perhaps 
even be argued that the use of the word " recipe " or its abbrevia- 



202 APPENDIX. 

tion, "R", is a reminder, not particularly of the Jupiter invocation, 
but of invocations in general, because it can be historically shown 
that prescriptions previous to the introduction of invocations as 
superscriptions had no superscriptions, but began abruptly with an 
enumeration of the ingredients, as is now the practice in the 
United States Pharmacopoeia. 

As far as I can find, ^ was a form of commencing a prescription 
which is centuries older than the use of either the word "recipe" 
or the simple letter R, and ^ was interpreted as "recipe" long 
before it was written that way; it is the object here to try to account 
for the little cross-stroke at the tail-end of the character ]$, and to 
explain why this sign or character is used instead of the letter R at 
the beginning of the prescription. 

In Rome, at a quite early time, many of the physicians were 
Greeks or Jews, who had accepted the Christian faith. Under the 
Roman emperors the practice of medicine was under strict govern- 
mental control and supervision. During the persecutions under 
Nero, Tiberius, Severus and other Roman emperors, Christians were 
cruelly put to death unless they saved themselves by making offer- 
ings or prayers to Jupiter and the other heathen gods in the temples, 
so that consent to offer or pray to Jupiter became a test to distin- 
guish between Christians and good Roman citizens. 

An invocation to Jupiter may thus have come to be compulsory 
on the prescription to prove the adherence of the physician to the 
old state religion. Consider also that, as early as during the reign 
of Nero (scarcely later than A. D. 50) persons suspected of being 
Christians were forbidden to practice medicine, and that as late as 
under Julian, near the end of the fourth century, no Christian 
teacher was tolerated in the medical schools; and that under 
Theodosius the Christian method of healing by laying on of hands, 
annointing, and by prayers, was forbidden; and that even as late 
as the sixth century it was not always safe to publicly avow one's 
religious belief, because now Christian, now Pagan physicians 
were persecuted and banished, according to the varying beliefs of 
the successive rulers. It was probably in times like these that 
physicians first found it convenient to have a sign which could be 
interpreted as an invocation of Jupiter, or as something else, when 
desired. Whether this was the reason or not, the historical fact is 
that Krinas introduced the astrological signs into medicine during 
the reign of Nero, or during the times of the fiercest and most cruel 
persecutions of the Christians. Magic, which had been practiced 
for a longtime previously, developed into alchemy, and this science 
was quite extensively practiced in the fifth century. By the slight 



i 



APPENDIX. 203 



alteration of the Jupiter sign A , by adding the stroke which 



^ 

fg , it became fg , 



makes it resemble the letter fg , it became fg , as it is 

even now frequently written, and physicians could claim it to be an 
invocation of Jupiter (the god), or the astrological sign for Jupiter 
(the planet), or the alchemistic symbol for Jupiter (the metal tin), 
or an abbreviation for " recipe'', just as convenience or necessity 
required. 

When Christianity gradually displaced heathenism, the minor 
gods first disappeared and the fight gradually became narrowed 
down to a contest for supremacy between Jupiter (the old supreme 
god) and Jehovah (the new and "only " god). Men ceased to pray 
to or swear by Mercury, Mars or Venim, but they invoked Jupiter, 
and they swore "by Jove'', and for purposes of strong affirmation, 
the God Jehovah has not succeeded in completely displacing 
Jupiter to this day, for we still swear "by Jove". 

Farther, I have no doubt that, as Jehovah crowded Jupiter more 
and more from his former high position, even though the necessity 
to use the symbol for Jupiter had ceased, some physicians who 
were half ashamed of their belief in the old god, and yet not pre- 
pared wholly to disavow it, added the little stroke to make / 

into fg , so that it might be considered to be the abbreviation 

for " recipe ". Or this may have been policy w T hen prescribing for 
patients who still believed in the efficacy of the old Jupiter conjur- 
ations even though the physician had ceased to believe in it. Thus 
it could mean " Jupiter" to a believer and "recipe" to a sceptic. 

Moreover, the " Jupiter theory n best accounts for the use of the 
cross, of the Abraxas symbols, of such words as "abracadabra" , 
"cum deo", or " in nomine dei", etc., these signs and words having 
been introduced by the early Christians as protests against the use 
of the symbols of Jupiter and of the other deities of the Olympus. 

Or suppose the mixing of the two entirely dissimilar things, the 

ancient Jupiter sign g and the letter R to have been the result 






of ignorance; or suppose even that the sign Jjr had been out 

of use for a thousand years and that then some one who saw that it 
had been used at the head of prescriptions in former times without 



204 APPENDIX. 

knowing why it was so used, should have used it and his example 
should have been followed until its use again became almost 
universal; or suppose any other manner to account for the fusion of 

the two signs g and gJ into if , the conclusion must be 



/^and^into^ 



the same. The symbol 1^ would never have come into existence and 
would never have been used at the head of the prescription if it had 

not been derived from the symbol g which meant an invocation 



% 



or conjuration of Jupiter. There is no other supposable reason why 
the letter R used at the opening of a prescription should have 
the little cross-line termination (Paris' "Cloven foot") when the 
letter R has no such form under any other circumstances whatever. 

This merging of the symbols must have occured during the 
transition period from the belief in the old mythologies to the newer 
Christian religion, and therefore in the earlier centuries of the 
Christian era, and in a time when writings for temporary purposes, 
as prescriptions, letters and messages of ephemeral character were 
still inscribed with a stile on wax tablets so that positive proof may 
be forever wanting, however convincingly logical reasoning and 
historical facts may establish the matter. 

To what extent this confusion between the Jupiter signs and the 
"Recipe" abbreviations was carried appears from the " Medi- 
cinisch Chemisch und Alchemistisches Oraculum", printed in 1783, 
from which the following symbols for "Jupiter" (tin) and 
"Recipe" are taken. 



Uecipe, %%L,<%cfa,4c 




Jupiter, T,<%> 7, U,<f? 
ftannixrn, ^,4,<£ C,W,^ 



APPENDIX. 20 5 



It is exceedingly curious to see that the sign for Jupiter, 



% 



(also called the Zadkiel or Zedekiel symbol, Zadkiel having been 
supposed to be an angel of the god Jupiter), was used for "recipe" 
as late as 1783, and that the letter R was used as a symbol for 
u Jupiter" (tin) but not as an abbreviation for "recipe", which is 
now its most obvious meaning. Note the practical identity of the 
first, fifteenth and seventeenth signs for Jupiter, and the fourth sign 
for "recipe"; the peculiar union of the second part of the sixteenth 
sign for Jupiter with the letter R in the first sign for " recipe "; 
the odd combination of the first, last part of the second and parts of 
the fourteenth signs for Jupiter to make the fifth sign for "recipe" — 
and there can be no doubt that the symbols for Jupiter and the 
signs for " recipe " and the letter R were at one time inextricably 
mixed, and even to a great extent synonymous; and I repeat again 
that there can be no reasonable doubt that 1^ was derived from 



^ 



and would never have existed as a sign at the head of the 



prescription if the latter sign had never been used as an invocation 
or conjuration of Jupiter. 

That ty is not the simple letter R any child can see. The letter B 
is never written ty anywhere else except at the beginning of a prescrip- 
tion. This fact demands an explanation which I attempt to give. 
It cannot have been due to accident; it is always more in accord- 
ance with our methods of thought to accept a fairly good explana- 
tion, rather than to believe in accident. No other explanation for 
the peculiar facts I have shown has ever been proposed, for I 
consider as altogether too puerile the attempt to explain Jty as being 
"Rp." The latter form is seldom used, is contrary to usual 
methods of abbreviating, and is so modern that it is at once appar- 
ent that it is derived from Jfy , and not vice versa. 

To conclude, the explanations here given to account for the little 
final cross-line in fy are fully as convincing as those given for hun- 
dreds of our customs, habits or beliefs which are traced back to 
former superstitions, beliefs, folk-lore, customs or habits, which are 
generally accepted as satisfactory, and I leave this subject to the 
judgment of my readers, whether there is or is not at least some 
foundation and room for the "Jupiter theory." 

O. A. W. 

St. Louis, Mo. 




In the early centuries of the christian era, amulets or charms against 
witchcraft, diseases and misfortune were much in vogue. I, II and III 
represent "Abraxas" medals, so called because the word "Abraxas" 
was a powerful word-charm (see page 187) . The letters a, &, r, a, x,a,s } 
in Greek, express the numeral 365. An Abraxas medal was any gem 
or talisman inscribed with mystical words or figures. The Romans 
used similar charms; and IV represents a priapic amulet (bearing the 
image of Priapus), used by maidens and matrons to prevent sterility* 
These priapic charms were often realistic figures of the phallus. 



INDEX 



Abbreviations of Latin words, 109 
Abstracts, 12. 
Aceta, 27. 
Acetomel, 17. 

"Ad" in prescriptions, 134, 169. 
Address of physician on prescrip- 
tion, 121. 
Adjectives, 75, 85. 

comparison of, 87. 

declension of, 86. 

list of, 90-102. 

numeral, 87. 
Adjuvant, 126. 
Adverbs, 76, 104. 
Age, influence of, on action of 

medicines, 146. 
"Ana" or "aa", meaning of, 104. 
Apothecaries' measures, 52. 

transposing to metric terms, 61. 
Apothecaries' weights, 45. 

transposing to metric terms, 61. 
Apparent discrepancies in stating 

doses, 140. 
Appendix, R, 200. 
Approximate measures, 70. 
AqusB, 27. 

Avoirdupois weights, 42. 
Base, 125. 

Baths, extemporaneous, 154. 
Blanks for prescriptions, 118. 
Bolus, 21. 

extemporaneous, 164. 
Bougies, 25. 
Case-book, 176. 
Cataplasms, 23. 

extemporaneous, 153. 
Cerates, 13. 

extemporaneous, 1H5. 
Changes of color in mixtures, 151. 
Charity patients, 120. 
Chartae, 20, 166. 
Chemical incompatibles, 149. 
Children, doses for, 139. 
Chirography in prescriptions, 118. 
"Cito," meaning of, in prescrip- 
tions, 120. 
Classification of prescriptions, 10. 
Climate, influence of, on action of 
medicines, 147. 



Coated pills, 163. 

Colatura, 14. 

Collodions, 13. 

Collyrium, 170. 

Color changes in mixtures, 151. 

Combination of remedies, 135. 

Comparison of adjectives, 87. 

Compound prescriptions, 10. 

Confections, 13. 

extemporaneous, 159. 
Conjunctions, 76. 
Conserves, 13. 
Conspergative, 124, 162. 
Construction of prescriptions, 74, 
105, 122. 

grammatical, 74. 
Conversion of apothecaries' 
weights to metric, 65. 

of metric to apothecaries' 
weights, 65. 
Corrective, 129. 
Date in prescriptions, 119. 
Declension, fifth, 85. 

first, 79. 

fourth, 84. 

of adjectives, 86. 

second, 80. 

third, 32. 
Declensions, 77. 
Decoctions, 14. 

extemporaneous, 171. 
Diluent, 133. 
Directive, 129. 

Discrepancies, apparent, in stat- 
ing doses, 140. 
Discs, 26. 
Doses, 139. 

apparent discrepancies in stat- 
ing, 140. 

for children, 139. 

fractiona 1 , 139. 

of different preparations of same 
drug, 140. 

unusually large, 140. 
Dragee, 21. 

Egyptian weights and meas- 
ures, 40. 
Electuaries, 13. 
Elixirs, 14. 



208 



INDEX. 



Emergency prescriptions, 120. 
Emplastra, 22. 
Emulsions, 15. 

extemporaneous, 172. 
Enemas, extemporaneous, 174. 
Excessive doses, 140. 
Excipients, 130. 

for pills, 161. 
Exclamation mark (!), meaning 

of, in prescriptions, 140. 
Explosive prescriptions, 150. 
Extemporaneous prescriptions, 
117. 

for baths, 154. 

for cataplasms, 153. 

for cerates, 165. 

for charity patients, 120. 

for confections, 159. 

for decoctions, 171. 

for emergency cases, 120. 

for emulsions, 172. 

for enemas, 174. 

for eye washes, 170. 

for gargles, 170. 

for infusions, 171. 

for inhalations, 154. 

for injections, 170. 

for liniments, 174. 

for lotions, 170. 

for lozenges, 164. 

for mixtures, 171. 

for neutral mixtures, 170. 

for ointments, 166. 

for paints, 175. 

for papers, 166. 

for pillows, 153. 

for pills, 159. 

for plasters, 165. 

for poor patients, 120. 

for poultices, 153. 

for powder in bulk, 155. 

for powders in divided doses, 
157. 

for rectal injections, 174. 

for repetitions, 175. 

for saturations, 170. 

for solutions, 168. 

for species, 153. 

for suppositories, 164. 

for tablets, 164. 

for teas, 153. 

for troches, 164. 

for washes, 170. 



Extracts, fluid, 16. 

liquid, 18. 

solid, 16. 
Eye washes, extemporaneous, 170. 
Fifth declension, 85. 
First declension, 79, 
Fluid extracts, 16. 

measures, 52. 
Fomentations, 24. 
Forms of formulae, 33. 

of medicines, 142. 
Formulae by " parts," 68. 

by "percentage," 69. 

by "proportion," 70. 

forms of, 33. 
Fourth declension, 84. 
Fractional doses, 139. 
Fresh herbs, tinctures of, 26. 
Gallipots, 19. 

Gargles, extemporaneous, 170, 
Glycerites, 17. 
Glycer6les, 17. 
Grains only as weights, 50. 
Grammatical construction of pre- 
scriptions, 74. 
Granules, 21. 
Habits, influence of, 146. 
Herbs, fresh, tinctures of, 26. 
History of Prescription, 179. 
Honeys, 17. 

How much to prescribe, 143. 
How to prescribe, 142. 
Idiosyncrasy, influence of, on action 

of medicines, 147. 
Incompatibles, 148. 

explosive, 150. 

chemical, 149, 

mechanical, 148. 

organoleptic, 149. 

therapeutical, 151. 
Indeclinable nouns, 85. 
Influences modifying action of medi- 
cines, 145. 

of age, 146. 

of climate, 147. 

of personal habits, 146. 

of idiosyncrasy, 147. 

of race, 147. 

of seasons, 147. 

of sex, 146. 

of time of day, 146. 
Infusions, 17. 

extemporaneous, 171. 



INDEX. 



209 



Inhalations, extemporaneous, 154. 
Injections, extemporaneous, 170. 
Inscription, 123. 

International weights and meas- 
ures, 54. 
Juices, 26. 
Language used in prescriptions, 73. 

advantage of Latin, 73. 
Large doses, 140. 
Latin language, advantage of, 73. 

phrases, list of, 113. 

words, list of 90-102. 
Linctus, 14. 
Linear measures, 53. 
Liniments, 18. 

extemporaneous, 174. 
Liquid extracts, 18. 

measures, 52. 

preparations, 166. 
Liquors, 23. 
List of adjectives and nouns, 90-102. 

of Latin phrases, 113. 
Littus, 175. 

Lotion, extemporaneous, 170. 
Lozenges, 26. 

extemporaneous, 164. 
Masses, 19. 
Mead, 17. 
Measures and weights, 36. 

Egyptian, 40. 

international, 54. 

metric, 56. 
Measures, apothecaries', 52. 

transposing to metric terms, 61. 

approximate, 70. 

linear, 53. 

liquid, 52. 
Mechanical incompatibles, 148. 
Medicines, combination of, 135. 

forms of administering, 142. 
Mel, 17. 
Metric prescriptions, 59. 

weights and measures, 56. 
Mineral waters, 27. 
Mixtures, 19. 

extemporaneous, 171. 

neutral, 170. 
Moxa, 26. 
Mucilages, 19. 
Name of patient on prescription, 

120. 
Neutral mixtures, extemporane- 
ous, 170. 



Nomenclature, iuo. 
Nouns, indeclinable, 85. 

list of, 90-102. 
Numeral adjectives, 87. 
Numeration, system of, 36. 
"Official" prescriptions, 10, 167. 
"Officinal" prescriptions, 10, 167. 
Ointment jars, 19. 
Ointments, 19. 

extemporaneous, 166. 
Oldberg's system of weights, 38. 
Oldest pharmacopoeia, 33. 
Oleates, 20. 
Oleoresins, 20. 
Olla, 19. 
Opodeldocs, 18. 

Organoleptic incompatibles, 149. 
" O. W. L," 163. 
Oxymel, 17, 27. 
"P." or "P. P.", 120. 
Pads, 23. 

Paints, extemporaneous, 175. 
Papers, 20. 

extemporaneous, 166. 
Papyrus, pharmacopoeia, 33. 
Participles, 80. 
" Parts," meaning of, 68. 
Parts of prescriptions, 105. 
Pastilles, 26. 
Patent preparations, 28. 
Patients' name on prescription, 120. 
Percentage formulae, 69 
Permanent presciptions, 10. 
Pessaries, 25. 

Pharmacopoeia, papyrus, 33, 
Phrases, list of Latin, 113. 
Physician's address on prescriptions, 

121. 
Pigmenta, 175. 
Pillows, 23. 

extemporaneous, 153. 
Pill excipients, 161. 
Pills, 20. 

coated, 163. 

extemporaneous, 159. 
Plasters, 22. 

extemporaneous, 165. 
Pomatum, 20. 

Poor patients, prescriptions for, 120. 
Poultices, 23. 

extemporaneous, 153. 
Powder in bulk, extemporaneous, 
155. 



210 



INDEX. 



Powders, 22, 155. 

in divided doses, extemporane- 
ous, 157. 
Preparations, liquid, 166. 

patent, 28. 

proprietary, 28. 

special, 152. 

solid, 153. 
Prepositions, 76. 
Prescribing, 142. 
Prescription blanks, 118. 

vials, 166. 
Prescriptions, classification of, 10. 

compound, 10. 

construction of, 74, 105, 122. 

date in, 119. 

emergency, 120. 

explosive, 150. 

extemporaneous, 117. 

for baths, 154. 

for cataplasms, 153. 

for cerates, 165. 

for charity patients, 120. 

for confections, 159. 

for decoctions, 171. 

for emergency cases, 120. 

for emulsions, 172. 

for enemas, 174. 

for eye washes, 170. 

for gargles, 170. 

for infusions, 171. 

for inhalations, 154. 

for injections, 170. 

for liniments, 174, 

for lotions, 170. 

for lozenges, 164. 

for mixtures, 171. 

for neutral mixtures, 170. 

for ointments, 166. 

for paints, 175. 

for papers, 166. 

for pillows, 153. 

for pills, 159. 

for plasters, 165. 

for poor patients, 120. 

for poultices, 153. 

for powder in bulk, 155. 

for powders in divided doses, 157. 

for rectal injections, 174. 

for repetitions, 175. 

for saturations, 170. 

for solutions, 168. 

for species, 153. 



Prescriptions — Continued. 

for suppositories, 164. 

for tablets, 164. 

for teas, 153. 

for troches, 164. 

for washes, 170. 

grammatical construction, 74 

magistral, 117. 

metric, 59. 

official, 10. 

officinal, 10. 

parts of, 105. 

permanent, 10. 

physician's address in, 121. 

simple, 10. 
Proprietary preparations, 28, 167. 
"Proportion," formulae, 70. 
Pulvis, 22. 

Quantities to prescribe, 143. 
" Q. S." or "quantum satis," 104. 
Race, influence of, on action of medi- 
cines, 147. 
Record of cases, 176. 
Rectalinjections, extemporaneous, 174. 

suppositories, 24. 

suppositories, extemporaneous, 164. 
Remedies, combination of, 135. 
Repetitions, 121. 

extemporaneous, 175. 
Resins, 22. 
Roob, 18. 
Rotulas, 26. 
Saponaments, 18. 

Saturations, extemporaneous, 170. 
Seasons, influence of, on action of 

medicines, 147. 
Second declension, 80. 
Sex, influence of, on action of medi- 
cines, 146. 
Signature, 138. 
Simple prescriptions, 10. 
Sizes of prescription vials, 166. 
Solid extracts, 16. 
Solutions, 23. 

extemporaneous, 168. 
Special preparations, 152. 
Species, 23. 

extemporaneous, 153. 
" Specifying" in prescriptions, 30, 167. 
Spirits, 24. 
Subscription, 138. 
Succus, 18. 
Superscription, 122, 200. 



INDEX. 



211 



Suppositories, 24. 

extemporaneous, 164. 

rectal, 25, 164. 

urethral, 25, 164. 

vaginal, 25, 164. 
Syrups, 25. 

System of numeration, 36. 
Table of approximate measures, 71. 
Table of equivalents of metric 
and apothecaries' weights, 65. 
Tablets, 26. 

extemporaneous, 164. 
Teas, 23. 

extemporaneous, 153. 
Therapeutical incompatibles, 151. 
Third declension, 32. 
Time of day, influence of, on ac- 
tion of medicines, 146. 
Tinctures, 25. 

of fresh herbs, 26. 
Tolerance of medicines, 146. 
Transposing apothecaries' meas- 
ures to metric terms, 61. 

apothecaries' weight to metric 
terms, 61. 
Triturations, 26. 
Troches, 

extemporaneous, 164. 



Troy weights, 44. 

Unguenta, 19. 

Unusually large doses, 140. 

Urethral suppositories, 25, 164. 

Vaginal suppositories, 25, 164. 

Vehicle, 124. 

Verbs, Latin, 102. 

Vials, 166. 

Vina, 27. 

Vinegars, 27. 

Washes, extemporaneous, 170. 

Waters, 27. 

mineral, 27. 
Weights and measures, 36. 

decimal, 54. 

Egyptian, 40. 

international, 54. 

metric, 56. 
Weights, apothecaries', 45. 

avoirdupois, 42. 

grains only, 50. 

metric, 56. 

Oldberg's system, 58. 

transposing apothecaries' to 
ric, 61. 

troy, 44. 
Wines, 27. 
Writing, in prescriptions, 118. 



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